Introduction: The aim of this study was to evaluate changes in the pharyngeal and lower facial morphology in Turkish female Class III patients 1.5 +/- 0.4 years after mandibular setback surgery (bilateral sagittal split osteotomy), and orthodontic multi-bracket treatment. Only women with mandibular prognathism were selected because sex differences in pharyngeal airway changes were evident. Material and methods: Lateral cephalograms of 25 Turkish female Class III patients (mean age: 25.4 +/- 2.6 years) with mandibular prognathism, were assessed before and 1.5 +/- 0.4 years after operation. Paired t and Pearson tests were used. Results: The pharyngeal airway morphology showed significant changes in soft-palate length and posterior reference line (PRL) to point of posterior tongue. The decrease in PTV-Pg distance was correlated with the decreases in PRL-PSP, PRL-PTO and PRL-E distances. It was considered normal for the pharyngeal airway morphology to adapt after surgery to improve the hard tissue relationship. Conclusion: The lower facial morphology significantly changed and the pharyngeal airway narrowed 1.5 +/- 0.4 years after mandibular setback surgery. (C) 2008 European Association for Cranio-Maxillofacial Surgery.