Objective To investigate the clinical efficacy of maxillary protraction combined with customized titanium plates in the treatment of skeletal Class Ⅲ malocclusion during the growth and development stage. Methods A total of 96 patients diagnosed with skeletal Class Ⅲ malocclusion who received treatment at our hospital between May 2021 and May 2023 were included in this study. Participants were randomly divided into two groups using a ball-drawing method： those assigned odd numbers were placed in the control group （n = 48）， while those assigned even numbers were allocated to the experimental group （n = 48）. The control group underwent maxillary protraction therapy alone， whereas the experimental group received maxillary protraction combined with customized titanium plate intervention. The two groups were evaluated and compared based on clinical effectiveness， facial soft tissue parameters （LL-EP， NLA， G-SnPg）， hard tissue parameters ［SNA （sella-nasion-A point angle）， SNB （sella-nasion-B point angle）， ANB （A point-nasion-B point angle）， MP-SN （mandibular plane-SN angle）， MP-FH （mandibular plane-Frankfort horizontal angle）， A-OLP （vertical distance from A point to occlusal line plane）， Pg-OLP （vertical distance from pogonion to OLP）， and Y-axis angle］， hyoid bone position， dental indicators （H-X， H-Y， H-MP， H-FH）， and the incidence of adverse events. Results Following the intervention， the experimental group demonstrated a significantly higher overall efficacy rate compared to the control group （P < 0.05）. The LL-EP value was significantly lower in the experimental group （P < 0.05）； conversely， SNA， ANB， MP-SN， MP-FH， A-OLP， and the Y-axis angle were all significantly increased （P < 0.05）. Additionally， H-X and H-Y distances were notably shorter （P < 0.05）， while U1-NA was greater and overbite depth was reduced in comparison to the control group （P < 0.05）. No statistically significant difference was observed in the incidence of adverse reactions between the two groups （P > 0.05）. Conclusion Maxillary protraction utilizing customized titanium plates can significantly improve clinical outcomes in patients with skeletal Class Ⅲ malocclusion， positively affecting both craniofacial hard and soft tissue structures， hyoid bone positioning， and dental parameters， while maintaining a favorable safety profile.