The aim of this study was to evaluate the impact of conventional and digital diagnostic wax-up on the axial tooth contour. Dental models of 15 patients were collected. Each model received conventional wax-up and digital wax-up. The conventional wax-up was based on tooth modification with dental wax on actual models. The digital wax-up involved fitting an average tooth form on virtual pretreatment models. Each wax-up model was digitally superimposed on the corresponding pretreatment model. For each modified tooth, analysis planes were extracted at three locations: mesial line angle, midtooth, and distal line angle. The impact of the following variables was evaluated: interarch location (maxilla vs mandible), intra-arch location (anterior vs posterior), tooth category (incisors, canines, premolars, and molars), and tooth location (midtooth vs line angle). The axial contour of the modified teeth increased after each wax-up, and this increase was directly proportional to the distance from the gingival margin. There is a clear tendency for the digital wax-up to cause a greater contour increase than the conventional wax-up. The anterior teeth were associated with a greater tooth contour increase than posterior teeth and the contour of the molars was the least affected. Although the conventional wax-up contour alteration was significantly less than for the digital wax-up, the actual difference was minimal.