An impacted or missing permanent tooth can add significant complications to an otherwise straightforward case. When multiple impacted teeth are present, the case complexity increases further. Developing a treatment sequence, determining appropriate anchorage, and planning and executing sound biomechanics can be a challenge. The following case report illustrates a patient with three retained primary teeth and three impacted permanent canines. After careful treatment planning and extraction of multiple primary teeth;, followed by attempted guided eruption of impacted teeth, the patient finished with a significantly improved functional and aesthetic result.