Oral clefts are among the most common of all birth defects. The exact etiology of palatal clefting is unclear, however, it is believed to be a multifactorial disruption of embryologic morphogenesis. Evaluation of these patients is complex and requires a thorough understanding of palatal anatomy and embryology. A team approach is used to addresses the varied anatomic, genetic, and psychosocial issues that surround these patients and their families. This article reviews the anatomy, embryology, epidemiology, diagnosis, and treatment of children with cleft palate.