Amelogenesis imperfect (AI) is a hereditary dental condition that affects tooth enamel, resulting in small and discolored teeth, tooth sensitivity, poor esthetics, and anterior open bite associated with severe discrepancy in the vertical relation of the jaws. Treatment can be complex and includes an interdisciplinary approach involving orthodontics, oral surgery, and restorative therapy. The purpose of this report is to describe the case of a 12-year-old girl with AI and severe open bite who received conservative, non-surgical therapy that led to good functional occlusion and acceptable dental and facial esthetics. A three-year follow-up showed excellent post-treatment stability.