A survey was made of the upper cervical vertebrae in children with cleft lip and palate in order to determine the prevalence of cervical vertebral anomalies. The cleft sample consisted of 105 patients attending for orthodontic treatment. It was subdivided into cleft lip (CL), cleft palate (CP), unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) subgroups. A control was comprised of 120 orthodontic patients. The cervical vertebral anomalies were classified into two types, posterior arch deficiency (PAD) and fusion anomalies (FUS). The results confirmed that the cervical vertebral anomalies occurred significantly more often in the cleft sample (13%) than in the controls (0.8%), p less than 0.001. The total prevalence of cervical vertebral anomalies was similar in the four cleft sub-samples, but the occurrence of each of the two types of cervical vertebral anomalies showed a more differentiated pattern. Posterior arch deficiency occurred significantly more often in cleft palate (CP), (16%) than in controls p less than 0.001, but fusions did not occur more frequently in any cleft groups than in controls.