This study aimed to evaluate craniofacial cephalometric morphology in patients with unilateral clefts (UCLP) and in those with bilateral clefts (BLCP). The lateral radiographs of 129 patients with UCLP or BCLP referred to San Bortolo Hospital in Vicenza between January 2010 and January 2019 were retrospectively evaluated. Fourteen cephalometric hard tissue landmarks per radiographs were digitized and fifteen measurements (eight angle measurements, six linear measurements, and one ratio measurement) were calculated. Statistical analyses were carried using Chi-squared test (P<0.05). The analysis included 33 patients (25%) with BCLP, 41 (32%) with right UCLP and 55 (43%) with left UCLP. Adjusting for age and sex, left UCLP was associated with lower gonial angle (mean difference [MD] -2.7, 95% CI 5.2 to -0.0), lower upper gonial angle (MD -2.2, 95% CI -3.9 to -0.6) but higher posterior facial height (MD 2.4, 95% CI 0.3 to 4.4) with respect to right UCLP. Adjusting for age and sex, BCLP was associated with lower articular angle (MD -2.8, 95% CI -5.5 to -0.2) but higher SNA (MD 2.6, 95% CI 0.6 to 4.6) and higher ANB (MD 3.2, 95% CI 1.3 to 5.0) with respect to UCLP. Differences between the two groups were found in relation to three cephalometric values: articular angle, that is bigger in UCLP patients; SNA, that is bigger in BCLP patients; ANB, that is bigger in BCLP patients. This different craniofacial morphology can influence the treatment plan in cleft lip and palate patients.