Patient waiting time was introduced to orthodontic clinics in 2009 as a Key Performance Indicator (KPI) in the Ministry of Health Malaysia (MOH) as a measure of client satisfaction. A cross-sectional pilot study was carried out in 2009 in all four main government orthodontic clinics in Selangor. The objectives were to measure patient actual waiting time and evaluate conformance to this KPI. The sample comprised of 5,286 patients; 9.2% from Tanjung Karang, 37.1% Kajang, 29.3% Klang and 24.4% Shah Alam. There were 33.8% punctual, 44.2% early and 21.9% late patients. The mean actual waiting time (AWT) in Selangor was 30 min (SD 24.7); shortest in Tanjung Karang (16.5min, SD 15.3) and longest in Shah Alam (47.9min, SD29.6). AWT was 21.9 min (SD 17.4) for patients punctual for appointments, 40.3 min (SD 40.3) for early patients and 21.9min (SD19.8) for late patients respectively. Although the mean AWT was long for early patients, 20% of them were seen earlier than their appointment time. All four clinics complied with the MOH KPI performance target (>50%) with a mean compliance of 87.5% for Selangor. There is statistically significant difference in punctuality of patients in different clinics (p