The primary function of the palate is to separate the nasal and oral cavities and facilitate the production of normal speech. The velar levator veli palatini (LVP) muscular sling is the palate speech motor. In the cleft palate, the LVP muscles are aberrantly sagittally oriented, which prevents their normal cranial, posterior, and lateral pull on the soft palate, resulting in velopharyngeal incompetence. Palatoplasty techniques enlist the same 3 principles: closure of the nasal mucosa, reorientation and repair of the LVP muscle sling, and closure of the oral mucosa. The primary outcome measures for palatoplasty are speech quality and palatal integrity.