PURPOSE: Alveolar bone grafting (ABG) has become increasingly utilized in cleft care, however, the ideal timing of ABG has yet to be standardized. This study aims to investigate the impact of the timing of ABG on postoperative complications. METHODS: A retrospective review of patients who underwent ABG using the National Surgical Quality Improvement Program-Pediatric database from 2012-2020 was performed. Demographics, comorbidities, and 30-day complications, including surgical site infection, wound dehiscence, reintubation rate, and blood transfusions, were collected. A receiver operating characteristic (ROC) curve was performed to determine the appropriate cutoff values for patient subgroups. RESULTS: Upon review, 5,719 patients underwent ABG, of which 103 (1.8%) had documented postoperative complications.Analysis of the data indicated that patients who had complications were older compared to those that did not (10.8±3.6 vs 10.1±2.8 years, p=0.021). A ROC curve analysis indicated a cutoff age of 12 years (AUC 0.57, p=0.044). Patients above the 12-year cutoff had higher rates of postoperative complications compared to those younger than 12 years of age (1.7 vs. 1.0%; p=0.030). CONCLUSION: Appropriate timing of ABG is essential for successful management of alveolar clefts. This analysis demonstrates a unique age-dependent rise in postoperative complications beyond 12 years of age. Surgeons performing ABG should consider early surgical intervention. A 12-year threshold should be considered for patients with alveolar clefts to reduce the risk of complications. Future studies should assess additional factors such as postoperative bone quality to further characterize the optimal timing.