Background <p>Children with cleft lip and palate (CLP) often face physical and emotional challenges impacting their quality of life. This study aims to assess the treatment outlook and concerns of school-going CLP patients from the perspective of pediatric dentistry in a tertiary healthcare setting in North India.</p> Methods <p>A cross-sectional, questionnaire-based study was conducted on 30 patients undergoing appliance therapy for CLP. The questionnaire, available in English and regional languages, included sections on general information, treatment, aesthetic, functional, and emotional aspects. Responses from children and their parents were analyzed, with chi-square tests used to evaluate associations between variables.</p> Results <p>Among participants, 76.6% were referred to pediatric dentists by surgeons, and 66.7% of those aged over 12 years had been receiving dental treatment for more than three years (<i>P</i> = 0.031). Dissatisfaction with facial appearance was reported by 56.7% of participants, with significant speech dissatisfaction noted particularly among children under 12 years (66.7%, <i>P</i> = 0.020). Emotional and social challenges included 56.7% struggling with oral recitation at school, affecting 75% of adolescents (<i>P</i> = 0.098). Furthermore, 46.7% expressed reduced confidence with intraoral appliances, especially males (53.3%).</p> Conclusions <p>This study highlights the crucial role of pediatric dentists in the comprehensive care of children with CLP, emphasizing the need for personalized dental treatment and interdisciplinary collaboration. Addressing functional and emotional well-being is essential to improve overall outcomes and quality of life for these patients.</p> Trial registration <p>Not applicable.</p>