Serial cephalometric studies have helped determine more or less normal patterns of growth for the bones of the face and skull. Similar studies on unoperated cleft palate cases through the second year of life show no significant difference from the normal pattern. A number of investigators strongly believe that the commonly used mucoperiosteal-elevating procedures result in deficient maxillary growth, severe malocclusions and the so-called “dish-face,” all due to interference with maxillary bone blood supply and the production of scar tissue on the maxilla. Some believe that if such procedures are contemplated they should be deferred until the end of the fifth year of life. Variations in the size and shape of the cranial base and nasopharynx may have a decided effect on speech results obtainable by closure of a cleft palate. The various Veau vomer flap and bone flap technics have been advocated by a number of surgeons to minimize poor end results. It is still the opinion of many that a properly performed one -or two-stage palate closure will not cause any more maxillary growth disturbance than one would find in an unoperated group of cleft palate cases. It is hoped that the many thorough quantitative and more objective studies now in progress will eventually give the best solution to the many problems so frequently faced in this type of case.