Background <p>Dental appearance significantly impacts self-perception, yet clinician-based indices often fail to capture the subjective nature of patient satisfaction. Despite the importance of patient-reported outcomes, their relationship with objective measures like the American Board of Orthodontics (ABO) Model Grading System remains under investigated. This study aimed to assess post-orthodontic patient satisfaction and determine its association with objective treatment outcomes, as well as various demographic and clinical factors.</p> Methods <p>This observational cross-sectional analytical study aimed to assess post-orthodontic patient satisfaction and to examine its association with objective treatment outcomes measured using the American Board of Orthodontics Model Grading System. A total of 197 patients (≥ 16 years) who completed orthodontic treatment at Cairo University were included. A cross-culturally adapted and validated questionnaire assessing ten satisfaction domains was administered using a 5-point Likert scale. The total satisfaction score was calculated as the mean of all items. Associations between satisfaction and demographic, clinical, and psychosocial factors were analyzed. Malocclusion classification and final treatment outcomes were evaluated using ABO model grading to correlate subjective satisfaction with objective measures.</p> Results <p>Class I malocclusion was the most common (50.7%), followed by Class II (34.5%) and Class III (14.7%). Overall, 81.7% of participants reported being satisfied or very satisfied, with a mean satisfaction score of 4.24 out of 5. Younger patients (&lt; 20 years) demonstrated significantly higher satisfaction levels (<i>p</i> &lt; 0.01). No significant associations were observed between satisfaction and gender, type of malocclusion, or ABO outcome grading. Motivation, pre-treatment concerns, and treatment-related discomfort were not significantly correlated with overall satisfaction.</p> Conclusions <p>Both adolescents and adults report high levels of satisfaction following orthodontic treatment, with adolescents reporting the greatest satisfaction. Patient-perceived success is not solely determined by objective clinical outcomes, highlighting the importance of addressing patient expectations and experiences during treatment.</p> Trial registration <p>This study was registered at clinicaltrials.gov on [15-06-2021] with the registration number NCT04928768.</p>