Continued advancement in the comprehensive care of children with cleft lip and palate has resulted in numerous innovative treatment protocols. The cooperation of numerous specialties has continued to expand the options for difficult cases. A high standard for aesthetic and functional results has been established. Presurgical treatment of a cleft alveolus and its associated soft tissues with presurgical orthopedics is just one of these techniques. Differing opinions of the effectiveness, growth disturbances, and additional costs of presurgical molding are often debated, but the concepts should be understood by any cleft surgeon or orthodontist involved in cleft care.