To test the hypothesis that there is no difference in the distal movement of the maxillary first permanent molars when cervical headgear is used alone or in combination with rapid maxillary expansion. The sample was composed of 36 subjects (aged 9 to 13 years), treated in the Faculty of Dentistry, Pontifícia Universidade Cat;aaolica, Rio Grande do Sul, Brazil. The individuals were in good health and in their pubertal growth period. All had Class II division 1 malocclusion. The patients were divided into two groups: group 1 (22 subjects), Class II, with a normal transverse maxilla treated with cervical traction headgear (HG) 400 g 12 h/d, and group 2 (14 subjects), Class II maxillary transverse deficiency treated with rapid maxillary expansion plus cervical traction headgear (RME + HG). An additional group 3 (17 subjects) served as a control group and included individuals with the same characteristics. All subjects had two lateral cephalograms: initial (T1) and progress (T2), taken 6 months later. Differences between T1 and T2 were compared with the Student's t-test, and three groups were compared by the analysis of variance and Tukey multiple comparison test. Results showed greater distal tipping and greater distal movement of the first permanent molars in group 1 (HG) than in group 2 (RME + HG), P < .05. No extrusion of first permanent molar occurred in either group (P > .05). The hypothesis was rejected. Cervical traction headgear alone produced greater distal movement effects in maxillary first permanent molars when compared with rapid maxillary expansion associated with cervical headgear.