Cephalometric analysis is an effective tool for the evaluation of craniofacial and pharyngeal changes in obstructive sleep apnoea. Meanwhile even for pharyngeal changes a lot of average values exist, which show significant differences for many cephalometric parameters. Approximately 40% of patients with obstructive sleep apnoea proved to have a retrognathic, dolichofacial appearance, which seems to contribute to obstructive apnoeas by retropositioning of the skeletal fixation for the muscles of the floor of the mouth and the tongue. Acoustic rhinometry for transnasal cross-sectional measurements of the upper airways is still under clinical trial. Whether it is a valuable supplement to cephalometric evaluation in the future will be mainly a question of software development.