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Objective: This cross‐sectional study analyzed the socio‐psychological need for orthodontic treatment in children and adolescents with and without Autism Spectrum Disorder (ASD) and its association with deleterious oral habits. Methods: Children/adolescents aged 6–14 years old, with and without ASD, and their respective caregivers were included. Caregivers completed a questionnaire addressing children and adolescents' deleterious oral habits. To assess the socio‐psychological need for orthodontic treatment, we utilized the aesthetic component of the Index of Orthodontic Treatment Needs (IOTN). Caregivers and an orthodontist independently used the standardized IOTN aesthetic attractiveness scale containing ten intraoral photographs and compared them with the most similar condition of the child/adolescent. Data collection occurred at two universities in northeastern Brazil and at an ASD referral center. Statistical analyses encompassed descriptive statistics, Shapiro‐Wilk, Kruskal‐Wallis, Mann‐Whitney, and Chi‐squared tests with linear trend (α5%). Results: The study involved 144 participants, evenly divided into two groups (ASD and non‐ASN). The ASD group showed higher average IOTN‐AC scores as evaluated by both professionals (mean score = 4.78 [± 2.34], p =.182) and caregivers (mean score = 4.31 [± 2.71], p =.992). Caregivers reported notably elevated IOTN‐AC scores in cases where onychophagy was absent (p =.049). Conclusions: Patients with ASD are indicated as having a relatively higher socio‐psychological need for orthodontic treatment. [ABSTRACT FROM AUTHOR]