Treatment results and compliance for orthodontic Medicaid patients were assessed and compared with non-Medicaid patients of similar initial severity. All 55 practices providing orthodontic treatment covered by Medicaid were asked to submit their last 5 Medicaid patients and 5 non-Medicaid patients of similar initial treatment complexity. Nine practices agreed to participate. Initial models, final models, and progress notes were obtained for all subjects. Casts were scored by using the peer assessment rating (PAR) index to obtain treatment result data. Progress notes were reviewed for compliance data. No significant differences were seen between the Medicaid and the non-Medicaid groups based on initial PAR, final PAR, or percentage of PAR reduction. No significant compliance differences were seen based on missed appointments, broken appliances, or number of poor oral hygiene comments. The Medicaid and the non-Medicaid patients in our study did not differ significantly in the effectiveness of treatment received or their compliance with treatment.