This study examined the changes seen on the submentovertex radiograph when the head is not extended sufficiently. A human dry skull supported on a cephalostat was used to simulate head extension. The range of rotation tested was an under-rotation of the skull of 30 degrees to an over-rotation of 10 degrees in intervals of 5 degrees. The measured variables were the intercondylar axis angles, corpus lengths and condylar widths. The relationships between skull rotation and changes in these variables were determined. Three selected landmarks, the spinosa points (right and left) and the pogonion point of each radiograph were located and compared spatially with the same points on the ideal radiograph. The results showed that variation in skull rotation affects both linear and angular measurements significantly (P < 0.01). Landmarks further away from the axis of rotation are affected by distortion more than those nearer to it.