Objective To explore the clinical value of Twin-block and muscle agonist in the treatment of patients with Angle's class Ⅱ with mandibular retrusion. Methods A total of 60 patients with Angle's class Ⅱ with mandibular retrusion admitted to the Fourth People's Hospital of Langfang from July 2019 to July 2022 were selected as the research objects. They were randomly divided into control group and study group, with 30 patients in each group. The control group was treated with muscle agonist function correction, and the study group was treated with Twin-block. The changes of dentofacial hard tissue, soft tissue profile and quality of life scores were compared between the two groups. Results The indexes of SNB, ANB, SN-OL, SN-MP, Go-pg and Goco in the study group were better than those in the control group, and the differences were statistically significant (P<0.05). The soft tissue facial angle, nasolabial angle, H angle, upper lip convex distance, lower lip convex distance and chin thickness index of the study group were better than those of the control group, and the differences were statistically significant (P<0.05). After treatment, the CPQ11-14 score of the study group was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Twin-block can achieve better results than muscle agonist in the treatment of patients with Angle's class Ⅱ with mandibular retrusion. Meanwhile, it can effectively optimize the profile of hard and soft tissues and improve the quality of life, which is worthy of clinical application.