Objective. The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. Materials and methods. Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. Results. With respect to controls, anterior (p < 0.05), middle (p < 0.01) and posterior (p < 0.05) cranial base lengths were increased, sella turcica was enlarged (p < 0.001) and upper spine morphology demonstrated differences in the height of atlas (p < 0.01) and axis (p < 0.05) in patients with acromegaly. Craniofacial changes were predominantly found in the frontal bone (p < 0.01) and the mandible (p < 0.05). As for the airway, patients with acromegaly exhibited diminished dimensions at nasal (p < 0.001), uvular (p < 0.01), mandibular (p < 0.01) pharyngeal levels and at the narrowest point of the pharyngeal airway space (p < 0.001) compared to healthy controls. Soft palate width was significantly higher (p < 0.001) and the hyoid bone was more vertically positioned (p < 0.01) in patients with acromegaly. Conclusions. Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.