Objective To investigate the improvement effect of maxillary protraction therapy on lateral cephalometric indicators in children with skeletal Class Ⅲ malocclusion in mixed dentition. Methods A total of 60 children with skeletal Class Ⅲ malocclusion in mixed dentition admitted to our hospital from February 2023 to February 2026 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 30 children in each group. The control group was treated with fixed orthodontic appliances, and the observation group was treated with maxillary protraction. The lateral cephalometric indicators, upper airway space indicators and complication rate were compared between the two groups. Results After treatment, the SNA and ANB in the two groups were larger than those before treatment, the SNB was lower than that before treatment, and the ANB in the observation group was higher than that in the control group (P <0.05). After treatment, the SPL in the two groups was lower than that before treatment, the PNS-R was higher than that before treatment, and the PNS-R in the observation group was higher than that in the control group (P <0.05). There was no statistically significant difference in SNA, SNB, SPL, SPT, and the incidence of complications between the two groups (P >0.05). Conclusion Maxillary protraction achieves favorable treatment effects for children with skeletal Class Ⅲ malocclusion in mixed dentition. It exerts prominent influences on craniofacial profile, modifies the morphology and position of dentition and jaw bones, and promotes the expansion of the upper segment and constriction of the lower segment of upper airway space, which is worthy of clinical application.