diff --git a/extensions/cornerstone/src/Viewport/Overlays/ViewportOrientationMarkers.tsx b/extensions/cornerstone/src/Viewport/Overlays/ViewportOrientationMarkers.tsx
index 3b7179b76..3bf776ed7 100644
--- a/extensions/cornerstone/src/Viewport/Overlays/ViewportOrientationMarkers.tsx
+++ b/extensions/cornerstone/src/Viewport/Overlays/ViewportOrientationMarkers.tsx
@@ -198,6 +198,9 @@ function _getOrientationMarkers(rowCosines, columnCosines, rotation, flipVertica
   const oppositeRowString = invertOrientationStringLPS(rowString);
   const oppositeColumnString = invertOrientationStringLPS(columnString);
 
+  // Round to 4 decimal places (after rotate right 3 times and flip horizontally -> rotation is 90.00000000000001)
+  rotation = Math.round(rotation * 10000) / 10000;
+
   const markers = {
     top: oppositeColumnString,
     left: oppositeRowString,