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Babies born with cleft lip and/or palate are followed-up throughout their growth in childhood. During adulthood, they may require further functional and/or aesthetic treatment. Adult multidisciplinary cleft clinics have been in place in the West Midlands, U.K. since June 2000. The aim of this study was to review the number and nature of problems these adult patients had and the types of treatment they required.All adult patients seen in 2004 were identified. Case notes were reviewed for patient epidemiology, problems at initial presentation, and interventions carried out until their last clinic visit in 2004.In 2004, there were 145 patients seen in the adult cleft clinic. Of those, 55 patients attended as part of their continuing care. Ninety were newly referred as adults to the cleft service. Patients ranged in age from 15 to 70 years and had, on average, three clinical problems each. One hundred and sixteen patients were listed for surgery of varying types, nine patients had nonsurgical speech-related intervention, 21 patients had restorative dental intervention, and 16 patients needed an extended clinical psychology assessment.For some patients who have had a cleft lip and/or palate, problems continue into adulthood or arise later in life. These problems are often multiple and treatment often requires the input of more than one specialist. The results of this audit support the need for coordinated multidisciplinary care for adults who have had a cleft lip and/or palate.