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Objective: The present study was conducted to evaluate the effectiveness of treatment outcome using American Board of Orthodontics (ABO) scoring and total treatment time between labial and lingual appliance and also to assess patients’ perception of the lingual appliance system. Materials and Methods: Twenty patients requiring first premolar extraction were selected; 10 patients were treated with a lingual and 10 with a labial appliance. The treatment duration and ABO scores were recorded from the posttreatment dental casts and orthopantomogram (OPG). A questionnaire was used to evaluate the perception of patients on lingual treatment using a visual analogue scale (VAS). Results: The total ABO scores of the 2 groups were not statistically significant. The lingual- and labial-appliance treatments were completed in 19.30 ± 7.50 and 22.40 ± 6.35 months, respectively. The VAS showed that lingual-appliance patients experienced a moderate amount of pain and discomfort to the tongue and soft tissues. Patients did not have considerable difficulty with speech and in maintaining oral hygiene. Conclusion: Lingual appliance cases finished with a comparable quality of orthodontic treatment precision well within the normal treatment time frame. These patients had moderate difficulties with speech, tongue irritation, and pain. They did not have difficulty in maintaining their oral hygiene and were satisfied with their smile and treatment outcome.