The reconstruction of cardiac ischemic regions from body surface potential measurements (BSPMs) is usually performed at a single time instant which corresponds to the plateau or resting phase of the cardiac action potential. Using a different approach, we previously proposed a level set formulation that incorporates the knowledge of the cardiac excitation process in the inverse procedure, thus exploiting the spatio-temporal correlations contained in the BSPMs. In this study, we extend our inverse level-set formulation for the reconstruction of ischemic regions to 3D realistic geometries, and analyze its performance in different noisy scenarios. Our method is benchmarked against zero-order Tikhonov regularization. The inverse reconstruction of the ischemic region is evaluated using the correlation coefficient (CC), the sensitive error ratio (SN), and the specificity error ratio (SP). Our algorithm outperforms zero-order Tikhonov regularization, specially in highly noisy scenarios. © 2015 CCAL.