Mandibular Distraction osteogenesis (MDO) has several advantages, including simpler technology, reducing the Morbidity (e.g., infectious blood loss, surgery time), and the ability of the mandible to lengthen smaller. Poor growth can affect the mandible or specific parts such as the body, branch, condyle, symphysis, and alveolar segments in the three levels. Mandibular hypoplasia is a typical misalignment of the teeth and jawbone that depends on gravity. The combination of orthodontic treatment and surgical intervention may be required for best results.A 19-year-old Saudi female high school student visited the clinics with no significant medical problem or medication history. Past dental history indicated multiple extractions, multiple dental restorations; orthognathic surgery was done five years ago but was failed due to osseous infection. The patient was briefed about the preventive measures needed, the treatment plan was discussed, the time required and cost details were informed. Mandibular distraction with anterior implants provided excellent clinical outcomes and high patient satisfaction.