Introduction: Temporomandibular joint (TMJ) disorders encompass a wide range of conditions impacting the joint and its surrounding structures, often leading to pain, dysfunction, and structural alterations. Understanding the predictors of condylar changes is crucial for early diagnosis and effective management, particularly in patients experiencing significant functional limitations. Objectives: This study aimed to examine the combined impact of sex and cortication classification on mandibular condylar changes, as detected by cone-beam computed tomography (CBCT), to identify key predictors for TMJ degeneration. Methods: A cross-sectional study was conducted on 64 patients (33 men, 31 women) aged 30 years and older, who underwent CBCT imaging. Demographic data (age, sex), dental factors (remaining teeth count, posterior tooth loss), and anatomical measurements (condylar height, width, length, and cortication on the mandibular condyle [CMC]) were analyzed. Condylar changes were classified as osteophytes, flattening, sclerosis, erosion, or pseudocysts. Chi-square tests, independent t-tests, and logistic regression were applied to identify predictors of condylar changes. Results: Women showed a significantly higher likelihood of condylar changes than men, with an odds ratio (OR) of 0.18, suggesting men were 82% less likely to exhibit these changes. CMC classification also played a significant role; individuals with CMC classifications of 0 or 1 had a 7.5 times higher risk of condylar changes than those with CMC class 2. Additionally, reduced condylar height was significantly associated with degenerative changes (mean height: 20.49 ± 2.5 mm in affected individuals versus 22.34 ± 3.2 mm in unaffected individuals, p = 0.017). Conclusion: The study concluded that both sex and CMC classification are significant predictors of condylar changes in TMJ disorders. Copyright © 2025 Agus Ertanto et al. International Journal of Dentistry published by John Wiley & Sons Ltd.