Objective:Exploring the impact of adenoid hypertrophy induced oral respiration on the developmental characteristics of craniofacial features in children and related factors.Methods: This study included 72 children from February 2024 to June 2025, including 36 children with adenoid hypertrophy accompanied by oral breathing (experimental group) and 36 healthy children without adenoid hypertrophy and oral breathing (control group). The craniofacial development indicators of the two groups of children were measured and compared through X-ray lateral cephalograms, and correlation analysis was conducted.Meanwhile, multivariate regression analysis was conducted to identify the independent risk factors influencing cranio-maxillofacial development in children.Results: Comparison of two groups of craniofacial development indicators showed that the experimental group had lower levels of SNB, Pog-NB, S-Go/N-Me, Co Go, maxillary width, and mandibular width than the control group, while the levels of ANB, MP-SN, and Y-Axis were higher than the control group (P<0.05); The age of onset of oral breathing is positively correlated with SNB, Pog-NB, S-Go/N-Me, Co Go, maxillary width, and mandibular width, and negatively correlated with ANB, MP-SN, and Y-Axis (P<0.05); The duration of oral breathing is negatively correlated with SNB, Pog-NB, S-Go/N-Me, Co Go, maxillary width, and mandibular width, and positively correlated with ANB, MP-SN, and Y-Axis (P<0.05)；Multivariate regression analysis showed that mouth breathing caused by adenoid hypertrophy, the age of onset of mouth breathing, and the duration of mouth breathing were independent risk factors affecting craniofacial development (P < 0.05).Conclusion: Adenoid hypertrophy induced oral respiration has significant adverse effects on the development of craniofacial features in children, and is closely related to the age of onset and duration of oral respiration in children.