Purpose: This study aimed to compare orthodontic treatment outcomes in maxillary protrusion enhanced by piezoelectric Corticotomy with and without bone graft guided by 3D surgical template. Subjects and Methods: sample of 20 patients with age range (18-25) year-old allocated randomly into 2 groups, Group I: patients were treated with piezocision corticotomy without bone graft guided by surgical template. Group II: patients were treated with piezocision corticotomy with bone graft guided by surgical template. Treatment changes were evaluated for each group and compared between groups. Data were analyzed using Paired t-test for each group and Student t-test to compare between the two groups. Results: There was a significant decrease in mean SNA, ANB, H angles, SN-U1, MP-L1, overjet measurements and significant increase in mean interincisal and nasolabial angles for both groups. While there was a non-significant difference between mean differences in skeletal, dental and soft tissue measurements between the two groups (p < 0.05). Both groups revealed decrease in the mean en masse retraction time. Conclusion: Maxillary protrusion cases treated with piezoelectric corticotomy revealed improvements in profile, esthetics and acceleration in orthodontic tooth movement.