Region growing is frequently applied in automated individual tree crown delineation (ITCD) studies. Researchers have developed various rules for initial seed selection and stop criteria when applying the algorithm. However, research has rarely focused on the impact of tree-oriented growth order. This study implemented a marker-controlled region growing (MCRG) algorithm that considers homogeneity, crown size, and shape using airborne laser scanning (ALS) data, and investigated the impact of three growth orders (i.e., sequential, independent, and simultaneous) on tree crown delineation. The study also investigated the benefit of combining ALS data and orthoimagery in treetop detection at both plot and individual tree levels. The results showed that complementary data from the orthoimagery reduced omission error associated with small trees in the treetop detection procedure and improved treetop detection percentage on a plot level by 2%–5% compared to ALS alone. For tree crown delineation, the growth order applied in the MCRG algorithm influenced accuracy. Simultaneous growth yielded slightly higher accuracy (about 2% improvement for producer’s and user’s accuracy) than sequential growth. Independent growth provided comparable accuracy to simultaneous growth in this study by dealing with overlapping pixels among trees according to crown shape. This study provides several recommendations for applying region growing in future ITCD research.