To evaluate the clinical effect of combined orthodontic and orthognathic treatment with invisible aligner technique without brackets in skeletal Class Ⅲ patients with facial asymmetry.A total of 24 skeletal Class Ⅲ patients with facial asymmetry treated with combined orthodontic and orthognathic treatment during the past 4 years were reviewed. Patients in the experimental group(n=12) were treated with invisible aligner technique without brackets, while patients in the control group(n=12) were treated with traditional fixed orthodontic technique for pre- and post-operative orthodontic treatment respectively. The cephalometric parameters and satisfaction questionnaire scores of the two groups before and after treatment were compared and analyzed with SPSS 20.0 software package for t test and Wilcoxon rank sum test, respectively.After treatment, the cephalometric parameters of SNA, SNB, ANB, U1-SN and L1-MP values were changed significantly(P<0.05), but there was no significant difference between the values of experimental group and the control group(P>0.05). The scores of aesthetics, comfort, portability, masticatory and speech function in the experimental group were significantly higher than those in the control group(P<0.05). The satisfaction scores of the two groups were both 8.8±0.5(P>0.05).Skeletal Class Ⅲ patients with facial asymmetry could obtain good clinical effect by using invisible aligner technique. The patients were satisfied with the aesthetics, comfort and the effect of combined invisible orthodontic and orthognathic treatment.