Objective To explore the effect of extraoral arch appliance therapy on oral satisfaction in patients with Angle class Ⅱ malocclusion. Methods A total of 40 patients with Angle class Ⅱ malocclusion admitted to Xining Stomatological Hospital from September 2023 to September 2024 were selected, and they were divided into the reference group and the experimental group by the random number table method, with 20 patients in each group. The reference group received traditional orthodontics treatment, and the experimental group received extraoral arch appliance therapy. The treatment success rate, craniomaxillofacial hard tissue indicators, craniomaxillofacial soft tissue indicators and oral satisfaction were compared between the two groups. Results The success rates of the experimental group at 3, 6, 9 and 12 months after treatment were higher than those of the reference group (P<0.05). At 12 months after treatment, the levels of UI-NA and SNA angle in the experimental group were lower than those in the reference group, while the level of LI-NB was higher than that in the reference group (P<0.05). At 12 months after treatment, the levels of Sn-H, LL-H and H angle in the experimental group were lower than those in the reference group (P<0.05). At 12 months after treatment, the scores of masticatory function, aesthetics and comfort in the experimental group were higher than those in the reference group (P<0.05). Conclusion Extraoral arch appliance therapy can effectively relieve the abnormal molar relationship in patients with Angle class Ⅱ malocclusion, and shows a good effect in improving craniomaxillofacial hard and soft tissue indicators. This method also improves the patients' oral satisfaction, with a more ideal overall therapeutic effect.