Facial clefts are disfiguring anatomic distortions of the face and cranium with deficiencies or excesses of tissue in a linear pattern that occur along predictable embryologic lines. The most commonly used classification of facial clefts was proposed by Tessier and numbers clefts from 0 to 14 depending on their relationship to the orbit. The orbit divides clefts into cranial (upper) and facial (lower) clefts. The clefts are numbered such that the facial component and cranial component of the cleft always add to 14. The soft tissue and skeletal abnormalities associated with each cleft are reviewed below in addition to generalized principles of surgical management in the correction of these disfiguring phenomena. Hypertelorism and its correction, including orbital box osteotomies and facial bipartition, are also reviewed.