The aim of this retrospective study was to evaluate the treatment outcome of lower incisor extraction and to compare it with premolar extraction and non-extraction treatment. The sample consisted of 60 subjects with Class I malocclusion and moderate crowding. The sample was separated into three groups: extraction of a lower incisor group, extraction of a four first premolar group and a non-extraction group. All groups involved 13 girls and 7 boys with a total of 20 patients. The Peer assessment rating (PAR) index was applied to a patient's pre-treatment (T1) and post-treatment (T2) dental casts. T1 dental casts were also used for determining Bolton discrepancy. One-way analysis of variance and post hoc Tukey HSD tests were used for statistical analysis. For the mean percentage PAR score reduction for each group, there was one significant difference seen between the lower incisor extraction group and the non-extraction group (P = 0.047). For the mean anterior ratios, there were significant differences among premolar extraction group versus non-extraction group (P = 0.042) and non-extraction group versus lower incisor extraction group (P = 0.000). For the mean overall ratios, there were significant differences among the premolar extraction group versus lower incisor extraction group (P = 0.048) and the non-extraction group versus lower incisor extraction group (P = 0.001). Orthodontic treatment without extraction has a better treatment outcome than the four-first premolar extraction and single lower incisor extraction protocols in Class I cases with moderate to severe mandibular anterior crowding.