Three-dimensional (3D) ultrafast imaging is important for ultrasound technology development. The traditional 3D imaging method based on fully sampled two-dimensional (2D) matrix often requires a large number of electronic channels with high density which limits the aperture size and imaging resolution in application. Recently developed row-column addressing (RCA) matrix effectively reduces the number of electronic channels from N× Nto N+ Nby addressing the row and column elements. The beamforming strategy designed for 3D ultrasound imaging was based on the coherent compounding of orthogonal plane waves (OPW). Such a multi-angle OPW compounding strategy achieves virtual transmit focusing in both directions by transmitting a set of plane waves in one direction and receiving along the orthogonal direction, which finally leads to an isotropic point spread function (PSF). In this paper, multi-angle OPW method was investigated for 3D blood flow imaging using an RCA matrix with 128 rows and 128 columns, centered at 6 MHz. The delay and sum (DAS) beamforming was developed for coherent OPW compounding, and the singular value decomposition (SVD) filtering method was used for separating the dynamic blood flow signals from the static tissue signals and low-amplitude noise. The Doppler velocity was computed by the autocorrelation method, and finally the 3D power Doppler and color Doppler imaging of the blood flow were realized. To evaluate the imaging quality and investigate the effect of different OPW tilting angles, quantitative analysis was carried out using multiple parameters, including –6 dB resolution measurements of the PSF, SNR of the power Doppler images and velocity distribution of the color Doppler. The –6 dB resolution is improved from 0.986 mm to 0.493 mm with the number of angles increasing from 5 to 33. With 17 plane wave angles, the SNR of the power Doppler image reaches 30 dB, and the average deviation between the velocity distribution along the diameter of the blood flow phantom and the actual value is about 26.0%. In conclusion, results show that the ultrafast 3D imaging method based on RCA matrix can obtain 3D B-mode, power Doppler and color Doppler images. Increasing the number of tilting angles and enlarging the angle range can significantly improve the imaging quality. The proposed method can be helpful for developing 3D ultrafast ultrasound Doppler imaging and functional ultrasound imaging based on neuro-vascular coupling.