OBJECTIVE The hearing status of children with orofacial clefts was analysed using objective hearing tests over an average of 38.7 months following soft palate closure. We investigated the influence of: timing of closure, type of cleft, importance of grommets insertion and concomitant craniofacial syndromes such as Pierre Robin (PRS). METHODS 70 children were selected for prospective audiometric testing twice yearly. RESULTS The average age at surgical closure was 8.3 months. More than half had PRS, but their hearing levels were not significantly different from those who did not. Neither did cleft type or timing of closure seem to have any influence. The portion of children with a hearing level better than 30 dB increased after repair from 38.6% to 81.4%--significant at 0.001 and remained stable more than 24 months later. In the group of children with concomitant grommets insertion, it was also found that also more than 80% achieved longstanding normal hearing. CONCLUSIONS There is no long lasting hearing loss which has any relevance to speech. The only intervention of any consequence is insertion of pressure equalising/tympanostomy tubes (grommets) in cases of primary palatal clefts when hearing is substantially impaired at the time of soft palate closure.