Orthodontists play a major role in management of patient of cleft lip and palate since birth. Patients with a cleft palate and or lip often require complex long-term orthodontic treatment, often in combination with a number of other specialists including maxillofacial surgery in order to produce a good facial appearance, with an esthetic, functional and stable occlusion. This chapter will specifically introduce the role of the orthodontic consultant in the management of the cleft lip and palate patient at multiple stages of their dental development and growth. The orthodontic burden of care for these patients is high and the duration of treatment will depend on the diagnosis and pattern of jaw growth and need for orthognathic surgery.