Objective To explore the effect of physiologic anchorage Spee-wire system (PASS) orthodontic technique in the treatment of borderline cases of Angle class Ⅱ division 1 malocclusion. Methods From January 2020 to December 2023, 29 borderline patients with Angle class Ⅱ division 1 malocclusion admitted to the Department of Stomatology, the Second Affiliated Hospital of Xinjiang Medical University were selected as the research subjects, and they were randomly divided into extraction group (n =14) and non-extraction group (n =15). The extraction group was given orthodontic treatment after extracting 4 first bicuspids, and the non-extraction group was directly given orthodontic treatment without extraction operation. Both groups were given PASS orthodontic technique, and the orthodontic effects were observed, while the soft and hard tissue indexes of maxillofacial region and the labial/lingual side alveolar bone thicknesses of maxillary anterior teeth were compared between the two groups. Results After orthodontic treatment, the upper and lower dentitions of 29 patients were aligned and leveled, the overbite and overjet of anterior teeth were within the normal range, the occlusal relationship of posterior teeth was good, and CBCT showed that the root movement of the upper and lower anterior teeth was controlled in the alveolar bone, without bone dehiscence,bone fenestration and other phenomena. After orthodontic treatment, the UL-EP and LL-EP of the extraction group were higher than those of the non-extraction group, and the differences were statistically significant (P <0.05). There was no significant difference in the SNA, SNB, ANB, Wits value, FMA, U1-NA, L1-NB, NLA and H-angle between the two groups (P >0.05). After orthodontic treatment, the labial side root apices of maxillary anterior teeth and the labial side 3/5 alveolar bone thickness in the extraction group were higher than those in the non-extraction group, and the differences were statistically significant (P <0.05). There was no significant difference in the lingual side root apices and lingual side 3/5 alveolar bone thickness between the two groups (P >0.05). Conclusion The effect of PASS orthodontic technique in the treatment of borderline cases of Angle class Ⅱ division 1 malocclusion is exact, and it can obtain good orthodontic effect by either extraction or non-extraction method, which can control the teeth roots in the alveolar bone, and achieve the normal the overbite and overjet of anterior teeth, but the change of the upper and lower lip position after extraction orthodontic treatment is more ideal than that after non-extraction orthodontic treatment.