Skeletal open bite is a complex and multifactorial anomaly. There are many reasons for the occurrence of open bite, including skeletal abnormal growth pattern; dental, respiratory, neurologic, and habitual factors; and tongue posture and function. Anterior open bite is one of the most difficult problems to treat in orthodontics. Various treatment modalities for the correction of an anterior open bite have been proposed such as extrusion of anterior teeth using intermaxillary elastics, multiloop edgewise archwire technique developed by Kim, inhibition of molar eruption using bite blocks and high-pull headgear during growth, and extraction therapy. The most effective treatment option in adult patients is the repositioning of both the maxilla and mandible through a surgical correction. Although satisfactory results can be achieved with orthognathic surgery, the complexity, risks and costs of surgery are disadvantages of the surgical treatment. With the advent of skeletal anchorage, a number of studies were released to introduce the treatment of anterior open bite by intrusion of maxillary posterior teeth. This report presents the treatment and long-term stability of an adult case of a severe anterior open bite treated by means of extraction of the 4 first molars.