Down's syndrome (DS) is a genetic disorder that results from a chromosomal abnormality due to trisomy of chromosome 21. Any disturbances during the early formation of the maxillofacial structures may lead to skeletal abnormalities. DS patients have been reported to experience malocclusions to a greater degree. Objective of this study is to investigate the skeletal abnormalities among DS patients. Subjects and Methods: The clinical examination and Cephalometric analysis were carried out for 30 DS patients and 30 control subjects. The prevalence of skeletal patterns were determined and compared to the findings of healthy controls. Results: Based on Cephalometric analysis, the most common skeletal arch relationship in DS was the Class III skeletal arch relationship as it was found in 16 (53.3%) with vertical growth pattern tendency and a more obtuse mandibular angle. Clinically the most common occlusal arch relationship was the class III, which was found in 70% of the patients. Descriptive characteristics such as cross bites, open bites were frequently observed in the DS group. Anterior open bite, anterior cross bite and posterior cross bites were found in 46.7%, 30% and 53.3% of the DS patients respectively. Conclusion: A significant difference is clear between DS subjects and controls when examining cephalometric radiographs regarding skeletal patterns as well as other clinical descriptive occlusal characteristics