ObjectiveTo investigate whether tooth removal at the time of secondary alveolar bone grafting (SABG) has any association with the surgical outcome and to assess the overall radiographic outcomes of SABG.DesignSingle-center retrospective cohort study.SettingTertiary UK cleft service.MethodsAny patient diagnosed with a cleft lip and/or palate aged under 16 years who had a SABG over a 3-year period (January 2021-June 2023) were included in the study. Patients with a craniofacial syndrome or those who had a repeat SABG were excluded. Two trained independent assessors were calibrated to use the Kindelan scoring index. Intra and inter-rater reliability was assessed using kappa statistics at the dichotomous level for the calibrated assessors (success vs failure). Chi-square tests were used to assess any associations (P < .05).ResultsNinety patients and 105 SABG (mean age 10.12 years SD 1.45) were included in the study. The overall success rate of the SABGs included was 85.7%. There were no significant differences in outcomes between those who had tooth extraction at the time of bone grafting (P > .05). There were also no statistically significant association between cleft type and cleft side and graft success.ConclusionsTooth extraction during the time of SABG surgery did not significantly influence its success. The results demonstrated that the SABG success rate was in line with the UK national outcome data.