A randomized controlled trial was conducted to compare the eff ects of rigid and wire fixation on health-related quality of life following surgical mandibular advancement in patients with Class II malocclusions. Sixty-four patients randomly selected to receive rigid fixation with bicortical position screws were compared with 63 patients randomly selected to receive nonrigid fixation with inferior b order wires. Quality of life was measured using the Sickness Impact Profile, a generic measure of health-related quality of life, and the Oral Health Status Questionnaire, a specific measure of oral health and function designed for use with orthognathic surgery patients. Patients were evaluated prior to application of orthodontic appliances, approximately 2 weeks before surgery, and 1 week, 8 weeks, 6 months, 1 year, and 2 years following surgery. Neither instrument revealed a statistically significant difference in quality of life between wire and rigid fixation at any time period. The health-related disability associated with Class II malocclusion is modest compared to many other medical conditions. Nonetheless, orthognathic surgery patients exhibit progressive and statistically significant improvement in health-related quality of life across a wide variety of functional domains, regardless of the fixation method used.