The "exclusively" orthodontic treatment of a malocclusion with class III sagittal skeletal relationships is preceded by a decision-making process, supported by scientific evidence, which is schematically developed in three points: 1. Analysis of the characteristics of the sagittal skeletal discrepancy and consequent possibility of performing an orthodontic compensation of the malocclusion; 2. Analysis of the patient's aesthetic expectations and evaluation of the possibility of aligning the aesthetic requests with the expected final outcome: face and smile; 3. Analysis of the type and extent of the crown-radicular displacement, also determined by the global complexity of the malocclusion, and consequent compatibility of the treatment with a favorable functional and periodontal outcome and with a medium-long term stability of the result. The described decision-making process based on scientific evidence will be illustrated in detail with the presentation of clinical cases taken from the personal clinical experience conducted with this type of malocclusion.