Objective To explore the inffuencing factors of smile aesthetic satisfaction in children with malocclusion after orthodontic treatment. Methods A total of 75 children with malocclusion who completed orthodontic treatment in Yangzhou Stomatological Hospital from January 2022 to October 2025 were selected. According to the smile aesthetic satisfaction after treatment, they were divided into the satisfaction group (n=65) and the dissatisfaction group (n=10). Univariate analysis and multivariate Logistic regression analysis were used to screen the independent factors affecting smile aesthetic satisfaction. Results Univariate analysis showed that there were no statistically signiffcant differences in age, gender, smile index and smile width between the satisfaction group and the dissatisfaction group (P>0.05). The smile height, canine width ratio, visible dentition width ratio and gingival exposure degree of the satisfaction group were lower than those of the dissatisfaction group, and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis indicated that smile height, canine width ratio, gingival exposure degree and visible dentition width ratio were independent risk factors affecting smile aesthetic satisfaction (P<0.05). Conclusion Smile height, canine width ratio, gingival exposure degree and visible dentition width ratio are independent risk factors affecting smile aesthetic satisfaction in children with malocclusion after orthodontic treatment.