<p>Cleft lip nasal deformity poses significant surgical challenges due to its multidimensional anatomical distortions and dynamic biomechanical interactions. Conventional approaches relying on two-dimensional imaging and empirical judgment fail to address the three-dimensional tissue mechanics governing nasal symmetry and airway function. This review demonstrates how finite element analysis (FEA) transforms cleft nasal reconstruction by integrating biomechanical precision with clinical translation. Patient-specific modeling based on CT/MRI data enables FEA to quantify stress–strain distributions during physiological loading, surgical manipulation, and long-term growth. Critical applications span multiple anatomical subunits including osseous, cartilaginous, muscular, and airway components. Closed-loop systems combining preoperative simulations with postoperative validation establish FEA as a transformative tool for precision reconstruction. We propose standardized “clinical data-FEA modeling-surgical validation” protocols to advance population-based biomechanical models toward personalized surgical navigation.</p><p><i>Level of Evidence IV</i> This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors &#xa0;<a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>