Orthognathic surgery has undergone multiple modifications in timing approaches, among them, surgery first represents an approach that potentially reduces length of time and shows earlier results in facial changes, nevertheless, it has been used mostly to treat Class III skeletal anomalies. Also, fixed appliances orthodontics is the most common choice, however, recent literature shows clear aligners can achieve the same results. This paper presents a case of a 20-year-old female with a skeletal Class II treated with surgery first and clear aligners protocol, with a literature review of surgery first in Class II patients; evidencing that this approach can be suitable to achieve satisfactory and stable results, although larger patient samples are needed.