Objective To analyze the effect of micro-implant anchorage-assisted maxillary expansion in patients with transverse maxillary hypoplasia. Methods A total of 60 patients with transverse maxillary hypoplasia who visited the Department of Orthodontics, Xiangtan Stomatological Hospital from October 2022 to October 2024 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 30 patients in each group. The control group was treated with traditional Hyrax rapid expansion device, and the observation group was treated with micro-implant anchorage-assisted maxillary expansion. The palatal suture expansion width, tooth inclination angle, maxillary width, treatment time and complications were compared between the two groups. Results The anterior, middle, posterior and total palatal suture expansion widths of the observation group were higher than those of the control group (P <0.05). After treatment, the inclination angle of teeth and the change value of angle in the observation group were lower than those in the control group, while the maxillary width and the increase value of width were higher than those in the control group (P <0.05). The treatment time in the observation group was shorter than that in the control group, and the incidence of complications was lower than that in the control group (P <0.05). Conclusion Micro-implant anchorage-assisted maxillary expansion has a good skeletal expansion effect in the treatment of transverse maxillary hypoplasia. It can effectively reduce compensatory tooth inclination, shorten treatment time, and reduce the incidence of complications, with definite clinical application value.