Abstract : A well-organized and efficient orthodontic service for any given population requires evaluation of therapeutic orthodontic needs and their difficulty the purpose is to assess the treatment need and the malocclusion complexity, and degree of improvement after completion of treatment. A randomly picked 60 pairs of study models (30 male and 30 female) were involved in this study for patients attending an orthodontic clinic at the College of the Dentistry/ University of Baghdad seeking treatment. The ICON scores were collected directly from the study model, photo and case sheet records. SPSS software version 25 has been used to analyze the results, 78.3 % of samples categorized as orthodontic treatment need, 21.6% belonged to the easy/mild categories and 58.3% classified as difficult or very difficult. There were no significant age or gender differences in the pre-treatment and in post-treatment ICON score. 98.3% scored as easy/mild categories post-treatment and 76.6% were greatly improved cases, substantially improved in 15%, while 6.6% moderately improved and only 1.7% was minimally improved. Assessing patients attending the hospital using ICON are valid to give priority to the most needed cases and can be applied before deciding to finish the case depending on the improvement grade