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Introduction: The term adenoid facies suggests a causal relationship between nasopharyngeal obstruction and facial hyperdivergence in growing subjects. The strength of this association is strongly debated and few “quantified” values exist. Materials and methods: A rapid online search was conducted on PubMed and Embase to identify key cephalometric studies comparing patients with nasal/nasopharyngeal obstruction to a control sample. A meta-analysis was carried out to quantify the effect of obstruction (1) and surgical relief (2) on mandibular divergence (SN/MP angle), maxillo-mandibular divergence (PP/MP angle), occlusal plane inclination (SN/OP), and gonial angle inclination (ArGoMe). Results: The included studies exhibited moderate to high levels of bias. Consistent findings demonstrated a significant effect of obstruction on facial divergence (1), with an increase in SN/MP (+3.6° on average, +4.1° in children ≤ 6 years), PP/MP (+5.4° on average, +7.7° ≤ 6 years), ArGoMe (+3.3°) and SN/OP (+1.9°). Surgical interventions to remove respiratory obstacles in children (2) generally did not normalize the direction of growth, with the exception (with a very low level of evidence) of adenoidectomies/adeno-tonsillectomies, performed at an age of less than 6–8 years. Conclusion: Early detection of respiratory obstacles and postural abnormalities associated with oral breathing appears to be decisive in effective management at a young age and normalization of the direction of growth. However, the effects on mandibular divergence remain limited and caution is required, and they cannot be considered a surgical indication.