Facial symmetry is an important factor of facial aesthetics. In the study of smile aesthetics, the concordance of dental midline and facial midline is closely related to evaluation of smile aesthetics. Dental midline deviation is quite common among general people. As a result, dental midline deviation is often the patient’s chief complaint, and dentofacial midline discrepancy is considered as an important diagnostic factor in orthodontic treatment planning. This article will make a review on the epidemiology situation, etiology classification of dental midline deviation, as well as its diagnosis, treatment and its influence on smile aesthetics.