Objective To analyze the effect of maxillary screw expander combined with anterior traction device on facial aesthetic effect and masticatory function in patients with maxillary hypoplasia. Methods A total of 80 patients with maxillary hypoplasia admitted to the Second People's Hospital of Jiulongpo District from January 2023 to January 2024 were selected, and they were divided into the control group (n =40) and the observation group (n =40) by the random number table method. The control group was treated with maxillary protraction orthodontics, and the observation group was treated with maxillary screw expander combined with anterior traction device. The detection indicators related to maxillofacial structure changes, masticatory function and treatment satisfaction were compared between the two groups. Results After treatment, all detection indicators related to maxillofacial structure changes in the observation group were better than those in the control group (P <0.05). The masticatory efficiency and occlusal force in the observation group after treatment were higher than those in the control group (P <0.05). The scores of overall aesthetics and dental functionality in the observation group were higher than those in the control group (P <0.05). Conclusion The application of maxillary screw expander combined with anterior traction device in the treatment of patients with maxillary hypoplasia can effectively improve facial aesthetic effect, masticatory function and treatment satisfaction, achieving a good therapeutic effect.