Objective To explore the facial aesthetic effect of micro-screw implant anchorage in the treatment of skeletal class Ⅱ malocclusion. Methods From January 2018 to December 2022, 66 patients with skeletal class Ⅱ malocclusion who were treated in Beijing BabyAlign Dental Clinicc were selected as the research objects. According to different treatment methods, they were divided into control group (n =33) and observation group (n =33). The control group was treated with extraoral arch anchorage, and the observation group was treated with micro-screw implant anchorage. The clinical efficacy, root resorption and facial aesthetic index changes were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.97%, which was higher than 75.76% in the control group (P <0.05). After treatment, the root volume of upper and lower central incisors, lateral incisors and canines in the two groups was less than that before treatment (P <0.05), but there was no significant difference between the two groups after treatment (P >0.05). After treatment, the SNA, SNB and ANB in the observation group were better than those in the control group (P <0.05). Conclusion Micro-screw implant anchorage combined with orthodontic treatment has a good effect on skeletal class Ⅱ malocclusion, which can better improve the facial appearance of patients and is worthy of clinical application.