Aim: Twenty patients with unilateral cleft lip and palate, orthodontically treated from the full primary or early transitional dentition stages until retention and dismissal, were recalled later in adult life to evaluate the status of their occlusion and facial appearance. Methods: Cephalometric radiographs, photographs, and casts were attained as final records. In several instances, final records were obtained by orthodontic colleagues at the patient’s current residence. Evaluation of the longitudinal records provided retrospective insight pertinent to the growth and positional relationships of the jaws’ contiguous structures and the dentition. Results: Orthodontic results are linked with observations related to the nasomaxillary complex: the anterior cranial base, tissue deficiency, the maxillary and mandibular dentition, and time modifications in skeletal facial growth. At adult ages, the patients with unilateral cleft lip and palate had acceptable facial profiles and acceptable alignment of the anterior dentition. Variances noted in mandibular pattern of growth explain attainment of acceptable relationships. In many cases, tissue deficiency in the anterior cleft region was compensated for with fixed partial dentures and removable prosthetic appliances. Posterior crossbites, although few in number, were proportionately more prevalent in this unilateral cleft lip and palate patient population than was anticipated; possible reasons are presented, taking into consideration congenital contingencies and therapeutic overlays. World J Orthod 2004;5: 152–163.