Anchorage control remains one of the most critical determinants of successful orthodontic treatment. Traditional anchorage methods often depend on patient compliance and may result in undesirable reciprocal tooth movement. The introduction of skeletal anchorage systems (SAS), including temporary anchorage devices (TADs), mini-implants, mini-plates, and orthodontic implants, has revolutionized modern orthodontics by providing absolute anchorage independent of patient cooperation. These systems enable complex tooth movements, reduce treatment time, improve biomechanical efficiency, and expand treatment possibilities for challenging malocclusions. This review examines the biological principles, classifications, clinical applications, advantages, limitations, and future developments of skeletal anchorage systems. Current evidence demonstrates that skeletal anchorage has significantly improved orthodontic outcomes and has become an integral component of contemporary orthodontic practice.