This case report evaluates the management of severely proclined maxillary dentition in a female patient having Class II malocclusion with lateral tongue thrust and multiple over-retained deciduous teeth. The case required extraction of maxillary 1st premolars for correction of the proclined and forwardly placed upper front teeth and was corrected with Pre-adjusted Edgewise bracket system. Clinical and cephalometric evaluation revealed skeletal Class II malocclusion with maxillary anterior proclination and an orthognathic facial profile, an average to vertical growth pattern, potentially incompetent lips, an increased overjet and overbite. Following fixed orthodontic treatment by removal of 1st premolars in the upper arch with retraction of anterior segment, a marked improvement in patient's smile, facial profile and occlusion was achieved and there was a remarkable increase in the patient's confidence and quality of life. The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with fixed appliance therapy.