Structured Abstract Objective To evaluate and compare three-dimensional pharyngeal airway changes in orthodontic patients treated with and without extractions. Material and Methods Pharyngeal airway was analyzed for 31 subjects (15 males, 16 females) treated with extractions of four first premolars and 31 age- and gender-matched controls (15 males, 16 females) treated without extractions. The mean age of subjects was 12.97 +/- 1.15years at the beginning and 15.69 +/- 1.28years at the end of treatment. The mean age of controls was 12.86 +/- 0.74years at the beginning and 15.18 +/- 0.86years at the end of treatment. Nasopharyngeal (NP) and oropharyngeal (OP) volumes, area of maximum pharyngeal constriction (AMPC), and upper arch perimeter were measured on T0 and T1 cone beam computed tomography (CBCT) scans. Paired samples t-test was used for analyzing statistical significance of changes (p0.05). Results There were no statistically significant differences in the pharyngeal airway values between the extraction and non-extraction groups at neither T0 nor T1. The extraction group showed a statistically significant increase for NP and OP volumes and AMPC values. Such increase was also noted in the non-extraction group, without statistical significance for AMPC values. Conclusions The findings suggest that an extraction or non-extraction choice for orthodontic treatment would not affect the pharyngeal airway.