The objective of this research was to study the impact of skeletal Class III malocclusion on patients' emotional status, as well as patients' motivations for seeking surgical correction of Class III malocclusion. The sample comprised 140 consecutive Chinese patients with skeletal Class III malocclusion who had been treated with a combined orthodontic-surgical approach. A retrospective analysis was performed, based on questionnaires with answers ranked on a numeric scale (O = not at all; 1 = a little; 2 = moderately; 3 = quite a bit; 4 = extremely). Sixty-seven percent of subjects (40 males and 54 females) returned completed questionnaires. Fifty-four percent had bimaxillary deformities, 32% had mandibular hyperplasia, and 14% had maxillary hypoplasia. Seventy-seven percent received bimaxillary surgery, 15% received maxillary advancement, and 8% received mandibular setback. The results showed that nearly half of the patients had a nickname related to their dentofacial problems, and 8 of 10 of these felt embarrassed or angry about their nickname. Ninety-three percent sought improvement of their facial appearance, 85% wanted an improvement in their dental appearance, and 73% desired an improvement in chewing ability. Seventy-six percent were concerned about surgical risks and 63% about possible pain. The vast majority of Class III patients undergoing orthognathic surgery suffered psychologic and functional problems related to their appearance prior to treatment. Esthetic improvement was the driving force behind seeking treatment.