Background: Class 2 Division 1 is the most prevalent type of malocclusion affecting about 32% of Pakistani population. With  upper maxillary premolar extraction is one of most frequent treatment choice.

Aim: To evaluate the effects of these extractions on soft tissue show variable results depending upon the sex, ethnicity, maxillary arch crowding and pretreatment structure of lips.

Methods: In this study pretreatment cephalograms of 106 Class 2 div 1 patients were taken whose treatment plan include extraction of maxillary 1st premolar. Then the second and final cephalograms were taken when retraction of incisors was completed. Mean changes in the position of upper and lower lip were measured with respect to Ricketts E-line before and after completion of retraction of maxillary incisors.

Results: After the extraction of premolars there is a significant (P value=0.000) reduction in the lip protrusion of -2.033mm±1.148mm and -1.695mm±1.628mm in both upper and lower lip respectively.

Conclusion: Extraction of maxillary premolars cause significant reduction of lip prominence and achieve facial esthetic balance.

Keywords: Class 2 div 1, lip position, Premolar Extraction