ObjectiveEvaluating the improvement rate of the scar according to the patient’s and observer’s opinions after treatment with the microneedling. Methods16 patients (12 females and 4 males), aged 16–30 years who had a cleft lip scare were included in the current study. All patients suffered from a visible defective scar in the upper cleft lip. All patients were treated with a microneedling pen device combined with a topical application of oil-based hyaluronic acid. The procedure was performed in 4 sessions performed with 3-week intervals between sessions. The scars were assessed by the patient and observer scar assessment scare (POSAS). ResultsAfter the treatment with the microneedling technique pain, itching, thickness, flexibility, color and relief were improved significantly (p < 0.05) (the improvement percentage: 36.6 %, 44.44 %, 67.28 %, 65.57 %, 59.79 %, 54.57 % respectively).According to observer’s opinion: vascularization, pigmentation, thickness, flexibility, topography and surface area were improved significantly (p < 0.05) after the treatment with the PCI technique (the improvement percentage: 40.60 %, 52.63 %, 61.55 %, 60.25 %, 53.72 %, 41.63 % respectively). ConclusionsThe microneedling treatment can be considered an effective method for the treatment of the defective scars resulting from the cleft lip plastic surgery. As well as, the microneedling technique is a simple, easy, safe, non-invasive, and low-cost procedure.