Objective: To assess the extent to which cephalograms modify therapeutic decisions related to early orthodontic treatment. Materials and Methods: Diagnostic records of six patients requiring early treatment were digitized for this purpose. A total of 234 orthodontists were then asked to select therapeutic measures on a treatment-planning sheet at two different times (T1 and T2). Three groups of orthodontists were formed and were provided with case-specific records either including or not including cephalograms and the appended tracing values. Forty-seven orthodontists completed all phases of the questions. Results: Statistical analysis revealed only two statistically significant differences between the first (T1) and second (T2) treatment plans, both concerning options of transverse treatment. None of the other results showed any significant changes from T1 to T2 treatment planning. Conclusion: It follows that cephalograms did not influence therapeutic decisions for early orthodontic treatment and should not be routinely used in very young patients. (Angle Orthod.