Objective To explore the effect of maxillary occlusal pad combined with anterior protraction in the correction of primary anterior crossbite in children and its influence on aesthetics. Methods A total of 60 children with primary anterior crossbite admitted to the Third People's Hospital of Bijie City from January 2023 to June 2024 were selected as the research subjects, and they were divided into the reference group and th e experimental group by the random number table method, with 30 children in each group. The reference group was treated with maxillary occlusal pad with lingual spring appliance, and the experimental group was treated with maxillary occlusal pad combined with anterior protraction. The cephalometric related indicators, aesthetics, clinical efficacy and recurrence were compared between the two groups. Results After treatment, the maxillary alveolar seat angle, mandibular alveolar seat angle, maxillary-mandibular alveolar seat angle and mandibular plane angle of the experimental group were better than those of the reference group (P <0.05). After treatment, the scores of facial symmetry, profile protrusion and lip-tooth relationship of the experime ntal group were higher than those of the reference group (P <0.05). The total effective rate of treatment in the experimental group (96.67%) was higher than that in the reference group (73.33%), and the recurrence rate was lower than that in the reference group (P <0.05). Conclusion Maxillary occlusal pad combined with anterior protraction has a definite effect in the correction of primary anterior crossbite in children. It can effectively improve the jaw relationship and facial aesthetics of children, with a low recurrence rate.