To explore the clinical efficacy of microscrew implant anchorage combined with MBT straight wire appliance in the treatment of Angle class Ⅱ malocclusion with maxillary protrusion. Methods A total of 70 patients with Angle class Ⅱ malocclusion with maxillary protrusion admitted to our hospital from January 2019 to September 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 35 patients in each group. The control group was treated with traditional anchorage and MBT straight wire appliance. The observation group was treated with microscrew implant anchorage combined with MBT straight wire appliance. The jaw bone index, maxillary tooth position and soft tissue status were compared between the two groups. Results There was no significant difference in SNA, SNB, ANB and GoGn-SN between the two groups after intervention (P >0.05). The OP-SN angle of the observation group was smaller than that of the control group after intervention (P <0.05). After intervention, the levels of U1-NA, Apg-U1 and Ptm-U6 in the observation group were lower than those in the control group (P <0.05). After intervention, the distance of U lip-E and L lip-E in the observation group was shorter than that in the control group, and the Z angle was larger than that in the control group (P <0.05). Conclusion The effect of microscrew implant anchorage combined with MBT straight wire appliance in the treatment of Angle class Ⅱ malocclusion with maxillary protrusion is definite, which can effectively improve the state of maxillary and lip process.