Abstract: The Herbst appliance, as a widely used functional orthopedic device for treating Angle Class II malocclusion in adolescents, has garnered significant attention for its mechanism of action and clinical efficacy. This article systematically reviews the multidimensional effects of the Herbst appliance on craniofacial structures, including alveolar bone remodeling, sagittal growth stimulation of the mandible, adaptive changes in the temporomandibular joint, and improvement in upper airway volume. Furthermore, it explores the long-term stability of treatment outcomes and provides a comparative analysis with other orthodontic appliances. Future research should prioritize the integration of biomechanical modeling, digital design, and material science advancements to enhance therapeutic predictability and minimize complication risks.