Maxillary deficiency, a common transversal dentofacial deformity, affects aesthetics and function. Timely intervention during adolescence is crucial, as the growth potential of the maxilla provides an opportunity to optimize treatment outcomes. This review explores various approaches for adolescent maxillary expansion, including orthopedic and surgical methods. Orthopedic appliances effectively address transverse deficiencies without surgery and are particularly beneficial in managing conditions in children and early adolescents. In mid- to late-stage adolescents, bone-borne devices with mini-surgery offer better skeletal expansion outcomes. However, in cases of severe deficiencies, or where skeletal resistance limits non-surgical methods, surgical interventions become essential. Procedures like surgically assisted maxillary expansion and orthognathic surgery offer superior skeletal corrections. These techniques are particularly valuable for late adolescents with complex conditions. This review comprehensively summarizes the applications, outcomes, and limitations of these treatment options, highlighting the importance of selecting individualized, growth stage-appropriate interventions.