There are currently no evidence-based guidelines about the use of antibiotic prophylaxis in repair of cleft lip and palate. After the designation of regional cleft centres in the UK, a postal questionnaire was sent to cleft surgeons in 2004 to enquire about the use of routine antibiotic prophylaxis for primary repair of cleft lip and palate. The results showed a lack of consensus and wide disparity among centres. The findings show that there is a need for a random control clinical trial to establish national recommendations for the rational use of prophylactic antibiotics in primary cleft surgery.