Dentofacial deformities are common in clinical practice, with diverse manifestations that not only affect facial appearance but may also lead to impaired mastication, speech, respiration, and temporomandibular joint function. For moderate to severe skeletal deformities, orthodontic treatment or surgery alone often fails to simultaneously achieve morphological reconstruction and stable occlusion. Combined orthodontic–orthognathic treatment has thus become a routine therapeutic option. In recent years, advances in digital imaging, three-dimensional virtual surgical planning, miniscrew anchorage, and clear aligner systems have enabled more refined diagnosis, treatment planning, and outcome prediction in combined therapy. This article briefly reviews the etiology and diagnostic essentials of dentofacial deformities, highlights the theoretical basis of orthodontic–orthognathic synergy, outlines major treatment models such as the classic three-stage approach, the Surgery-First approach, and integrated digital workflows, and discusses treatment strategies and key considerations for different deformity types including Class III, Class II, facial asymmetry, and vertical discrepancies. The application prospects of emerging technologies related to combined therapy are also briefly discussed.