Orthodontic cases involving the extraction of first permanent molars are usually technique sensitive and difficult to treat. Molars are seldom teeth of choice for extraction for orthodontic purpose because even when they are removed at the optimal time the contact relationship between second premolar and the 2nd molar is rarely ideal that even a good result is in some way a compromise. So in many cases that would benefit from sixes extraction, because of the doubtful long-term prognosis s are treated with the extraction of healthy premolars. Sothe aim of this article is to discuss a rationale for extraction of first molars and to highlight some of the problems which are faced by orthodontists in such cases and some of the solutions to overcome this problem.