The purpose of the current study was to evaluate the skeletal and dental effects of a modified vertical holding appliance (MVHA) in a group of Egyptian children. The sample included fifteen females from which ten received the modified vertical holding appliance for treatment for a period of six months and five acted as controls. Measurements were taken and compared before and after treatment using Cone Beam CT (CBCT). The results revealed that the appliance was able to induce forward and upward mandibular rotation as evident from the statistically significant decrease in the mandibular plane angle (SN/MP) and PP/MP and the increase in the facial axis angle (PtGn/NBa) and the SN-Pog angle as well as the ability of the appliance to induce bite closure, as confirmed by the significant increase in the overbite. Also a statistically significant amount of upper first molar intrusion was achieved, confirmed by the significant decrease in the U6-Palatal plane. Despite that, no statistically significant improvement was achieved in the soft tissue profile angle (n’sn pog’), but the soft tissue profile was improved clinically.