This chapter discusses cleft lip and cleft palate, where cleft lip may be of median, paramedian oblique or of transverse type. Ideal lip repair must achieve accurate approximation of skin, muscle and mucosa, minimal scar mark, properly aligned cupid bow, symmetrical nostrils and columella. In Millard’s repair method, philtrum of lip is rotated downward as a flap and lateral lip segment is advanced across the cleft. Ideal cleft palate repair should achieve one stage closure of cleft, no postoperative shortening of palate, adequate velopharyngeal competence, normal speech, and normal nasal physiology. Cleft palate occurs because of failure of fusion of median nasal process, maxillary process and alveolar process in the 8th-9th week of intrauterine life. Submucous cleft palate is a condition in which musculature of the palate is not present but mucosal coat is intact. Chronic secretory otitis media occurs because of E. tube dysfunction due to hypoplasia of levator palati and tensor palati muscles.