Occlusal asymmetries are common in orthodontic patients. A treatment option for correcting moderate asymmetries is asymmetric extractions. This study evaluated post-treatment dental arch symmetry in patients treated with unilateral premolar extractions. Post-treatment casts of 60 patients were divided into four treatment groups based on the history of occlusal asymmetry and the treatment plan. DesignCAD3000 software (Upperspace Corporation, Pryor, OK) was used to evaluate asymmetrically treated arches for symmetry. The four treatment groups were compared to identify differences in arch asymmetry based on treatment. The lateral incisor and canine were found to be more palatal on the extraction side in patients treated with unilateral extractions (P < .001). Arch length increased (P < 0.001) and area under the arch decreased (P < 0.01) on the extraction side. On average, patients with asymmetric extractions did not finish with more arch asymmetry than those without asymmetric extractions.