Cleft lip and palate is a common craniofacial anomaly, requiring complex multidisciplinary treatment and having lifelong implications for affected individuals. Children with cleft lip and/or palate are at risk for psychosocial problems due to multiple factors associated with the condition. Thus, a multidisciplinary approach is required to manage a cleft lip and palate patient for a better care.Pre-surgical Naso-Alveolar Moulding (PNAM) is an effective procedure to improve nasal symmetry in patients with unilateral cleft lip and palate in terms of nostril width, height and columella angle. In cases of incomplete cleft, patients also benefits from the decrease in alveolar cleft gap width. PNAM therapy has significant advantages in the treatment of bilateral cleft lip and palate patients. As a result, the changes associated with PNAM therapy help decrease the complexity of subsequent surgeries.