Orthodontic indications for lateral cephalograms are diagnosis, prescription, prediction and research. Benefits of taking these radiographs must be weighed against the risks of radiation exposure. Various cephalometric analyses have been described, and these are commonly used for diagnosis and treatment planning, but unavoidable errors of both projection and identification can complicate radiographic interpretation. The use of the cervical vertebral maturation technique for growth prediction has been contentious, but may have a useful role in aiding treatment timing. Research outcomes in orthodontics have focused heavily on cephalometrics, but this is starting to change, especially with the development of 3D analysis techniques. CPD/Clinical Relevance: The range of uses of lateral cephalograms in orthodontic practice and some of the latest research regarding the use of cephalometrics in treatment planning is described.