Skeletal anchorage systems have fundamentally transformed contemporary orthodontic and orthopedic practice by providing stable, predictable anchorage that eliminates dependency on patient compliance and expands the boundaries of achievable tooth movement and growth modification. This review synthesizes current evidence on the clinical outcomes of temporary anchorage devices (TADs), mini-plates, and hybrid anchorage systems across orthodontic and orthopedic applications. The aim is to provide clinicians and researchers with a comprehensive framework for understanding the biomechanical principles, methodological approaches, and translational implications of skeletal anchorage in interdisciplinary patient care. Key biomechanical frameworks examined include load distribution dynamics, cortical bone engagement principles, and force-vector optimization strategies. Clinical applications are reviewed across major therapeutic domains including intrusion mechanics, en-masse retraction, open bite correction, Class II and Class III growth modification, maxillary protraction, mandibular control, and skeletal expansion. Comparative evaluation of clinical outcomes reveals that mini-implants achieve success rates exceeding 85-90% when appropriately placed and loaded, with factors including insertion site bone quality, operator experience, and patient factors significantly influencing stability. Mini-plates demonstrate superior stability for high-force orthopedic applications but require more invasive surgical placement. Hybrid systems combining skeletal anchorage with conventional appliances offer enhanced versatility for complex cases. Patient-reported outcomes indicate high acceptance levels despite the minimally invasive nature of placement procedures. Implementation considerations include surgical training requirements, cost-effectiveness analysis, and integration within multidisciplinary treatment planning. Challenges and future directions encompass digital workflow integration, 3D-guided placement, AI-assisted treatment planning, personalized anchorage strategies, and multicenter translational research frameworks. The review concludes that skeletal anchorage, when appropriately selected and implemented within evidence-based protocols, represents a paradigm shift enabling predictable, efficient, and minimally invasive correction of complex dentofacial problems.