Craniomaxillofacial vertical skeletal pattern is closely correlated with the anatomical risk of upper airway obstruction. However, this association is frequently overlooked in the clinical practice of orthodontics and sleep respiratory medicine. In addition, existing studies have presented inconsistent conclusions due to differences in research populations, malocclusion types and measurement methods. This paper summarizes the latest research progress in this ffeld, systematically reviews the evolution of imaging techniques from two-dimensional cephalometry to three-dimensional CBCT measurement, and compares the differential effects of vertical skeletal patterns on the three-dimensional morphology of the upper airway among patients with individual normal occlusion and different types of malocclusion. It aims to provide a theoretical basis for early clinical identiffcation of high-risk populations and optimization of diagnosis and treatment strategies.