Objective To explore the effect of orthodontic extraction therapy on hard and soft tissue proffle indicators in skeletal class Ⅱ malocclusion adolescent patients with high-angle and low-angle vertical skeletal patterns. Methods A total of 102 skeletal class Ⅱ malocclusion adolescent patients with high-angle and low-angle vertical skeletal patterns admitted to Changsha Stomatological Hospital from January 2021 to January 2024 were selected as the research subjects. According to vertical skeletal angle difference, they were divided into the high-angle group and the low-angle group, with 51 patients in each group. The high-angle group and the low-angle group both received orthodontic extraction treatment. The hard and soft tissue proffle indicators were compared between the two groups. Results At 1 week after treatment, the Z angle, mentolabial sulcus angle and UL-E line in the low-angle group were higher than those in the high-angle group, while the LL-E line was lower than that in the high-angle group (P<0.05). At 1 week after treatment, the U1-SN angle and L1-NB angle of the low-angle group were larger than those of the high-angle group, the U1-NA distance and L1-NB distance were shorter than those of the high-angle group, and the Ptm-6 distance was longer than that of the high-angle group (P<0.05). There were no statistically signiffcant differences in SNA angle, SNB angle, ANB angle and U1-NA angle between the two groups (P>0.05). Conclusion For skeletal class Ⅱ malocclusion adolescent patients with high-angle and low-angle vertical skeletal patterns, orthodontic extraction therapy can improve their hard and soft tissue proffles. Patients with low-angle pattern gain more favorable improvement in soft tissue proffle, while high-angle patients achieve satisfying treatment effects in incisor retraction and molar mesial movement control.