Background: While planning for orthodontic/orthopedic treatment, using maturation indices to measure the skeletal maturity level is inevitable in evalating the patient’s growth. A new method is based on morphologic changes of cervical vertebrae which can be readily seen on lateral cephalogram. In this diagnostic study we aimed to compare this new method determining skeletal maturity level with conventional method (Hand-Wrist). Materials and Methods: 80 subjects (19 males and 61 females) contributed in the study. Each subject had a lateral Cephalogram and Hand-wrist radiogram taken simultaneously. Maturation level was diagnosed based on atlas vertebras, represented by both methods and in following, data were analyzed. Correlation coefficient between two methods was calculated by Spearman’s analysis and reliability of this new method of diagnosis the skeletal maturity was measured by McNemar’s statistical test. Results: The sensivity and specificity of lateral cephalogram were 98.2% and 88%, respectively. Also, the positive and negative predictive values were 94.7% and 95.6% for this modality. Correlation coefficient between both methods was 93%. The reliability and reproducibility of the new method in determining the skeletal maturity was 95%. Conclusion: High correlation and reliability obtained between both methods suggesting the applicability of the new methods to determine skeletal maturity.