The time at which orthodontic treatment should be started remains a matter of conjecture. Anomalies of dental development and functional problems tend to be addressed in the mixed dentition, while definitive treatment tends to be delayed until the late mixed dentition to maximize growth potential and patient compliance. However, some clinicians advocate starting treatment earlier in certain types of malocclusion. In this article, the current concepts of early treatment, both physiological and psychological, will be explored and the relevant indications and contraindications discussed.