Extraction has now been accepted widely in various malocclusions including Angle's class II division1. However, the levels of scientific evidence in orthodontic treatment planning have been weak, and it is unlikely to systematically provide a rationale and consistent basis in decisions of extraction. Angle's class II division 1 malocclusions exhibit various morphological characteristics. Orthodontists should comprehensively consider the reciprocal impact of multiple factors when choosing different extraction strategies for various malocclusions. Molar relationship, lower anterior crowding, Bolton index, facial growth pattern, degree of spee and anterior overjet are the various factors that determine the extraction decisions. This article describes the various factors influencing the orthodontic extraction decisions and discusses the various extraction patterns used in different malocclusions.