Abstract :Protraction face-mask (PFM) therapy is the most common approach for early treatment of Class III patients with maxillary deficiency. Main goal of the therapy is to achieve the orthopedic effect rather than dento-alveolar correction. Maxillary protraction combined with maxillary expansion simplifies maxillary advancement. On the other hand, early Class III treatment with PFM therapy generally needs patient’s cooperation. Effective protraction of maxilla is provided by disarticulation of maxilla from neighbor bones. The use of intraoral protraction spring (IPS) combined with the Alternate Rapid Maxillary Expansions and Constrictions (Alt-RAMEC) is preferred method recently not only to eliminate patient’s cooperation but also to disarticulate maxilla from the circum-maxillary sutures. The purpose of this case report is to evaluate the skeleto-facial effects of IPS combined with Alt-RAMEC in pubertal growth period by cone beam computed tomography (CBCT). Alt- RAMEC-IPS therapy affected the naso-maxillary structures entirely and showed significantly favorable effects on maxillary advancement. The use of Alt-RAMEC/IPS appears to be a promising treatment method instead of using PFM therapy.