Caring for the child with cleft palate requires a multidisciplinary approach that begins with evaluation for other possible congenital anomalies, decisions about timing of repair, and choice of techniques. Postoperative follow-up similarly requires a team approach and should include an otolaryngologist, an orthodontist, and a speech therapist. The art of cleft palate repair has enjoyed a decade rich in new developments. New techniques have been developed, and standard techniques have been refined. Most importantly, the need for prospective, randomized trials to objectively compare surgical techniques has been recognized. Initiation and completion of these trials will improve outcomes for patients with cleft palate repairs.