Ankyloglossia, commonly known as tongue-tie, is a congenital anomaly in which a short lingual frenulum or an attached genioglossus muscle restricts tongue movement. The diverse diagnostic criteria and the different types of tongue-tie could explain the variation in prevalence. The natural history is unknown. The clinical significance of ankyloglossia is a matter of controversy, particularly related with breastfeeding issues. Ankyloglossia does not cause speech or language delay. Indications for surgical release of ankyloglossia may include breastfeeding difficulty, articulation problems, psychological problems, and periodontal disease. The goal of surgery is increased mobility, not improved contour. The optimal timing for surgery is controversial. Evaluation by a speech pathologist is an essential component for the evaluation of children with ankyloglossia and articulation problems. When indicated, tongue-tie release or frenotomy is a quick and simple procedure that can be accomplished in an office setting at the time of the initial consultation. The infantile lingual frenulum tends to be thin and relatively avascular, resulting in minimal bleeding after the division.