Ultrasound vector Doppler techniques for three-dimensional (3-D) blood velocity measurements are currently limited by low temporal resolution and high computational cost. In this paper, an efficient 3-D high-frame-rate vector Doppler method, which estimates the displacements in the frequency domain, is proposed. The novel method extends to 3-D an approach so far proposed for two-dimensional (2-D) velocity measurements by approximating the (x, y, z) displacement of a small volume through the displacements estimated for the 2-D regions parallel to the y and x directions, respectively. The new method was tested by simulation and experiments for a 3.7 MHz, 256-element, 2-D piezoelectric sparse spiral array. Simulations were also performed for an equivalent 7 MHz Capacitive Micromachined Ultrasonic Transducer spiral array. The results indicate performance (bias ± standard deviation: 6.5 ± 8.0) comparable to the performance obtained by using a linear array for 2-D velocity measurements. These results are particularly encouraging when considering that sparse arrays were used, which involve a lower signal-to-noise ratio and worse beam characteristics with respect to full 2-D arrays.