Patients with lip and palate cleft often have difficulties in articulation, mastication, swallowing and esthetic problems. In general, these patients have characteristics of malocclusion that need special treatment. Interdisciplinary approach should be done. It would need long term of healing period after total reconstruction which includes physical, mental, emotional, and social condition. Orthodontic treatment in patients with lip and palate cleft consists of several stages which are the periods of infant, deciduous dentition, mixed dentition, and permanent dentition. These periods could be followed by pre-orthognathic surgical treatment if it is necessary. The principal of orthodontic treatment in patients with lip and palate cleft is to treat the malocclusion and to reduce the dysharmony that may happen due to surgical procedure which occurred during growth and development periods.