Background Severe skeletal class III malocclusions usually need a combined treatment of orthodontics and orthognathic surgery. Knowing about changes occurred following such treatments lead to improve facial esthetics and better treatment results. Objectives This study was done to determine cephalometric changes of facial soft tissue after combined treatment in patients with skeletal class III problem. Methods 25 patients with skeletal class III discrepancy who needed a combined treatment, were selected. Changes in nasolabial angle , upper lip and lower lip to E-line distance, angle of convexity , lip-chin-throat angle and lower anterior facial height were measured before and 6 - 12 months after surgery. Changes in parameters were analyzed with Paired t-test. Results Upper lip to E-line distance (P < 0.0001) and angle of convexity (P < 0.001) changed significantly following surgical procedures while changes of other parameters were not significant. Conclusions Clinical changes in the soft tissue following a combination of orthodontic treatment and orthognathic surgery in patients with skeletal class III discrepancy are significant while these changes mostly improves esthetics of patient’s facial profile.