In order to achieve a better speech result while eliminating the possible adverse effect to midfacial growth, a Furlow palatoplasty has been used for primary palatal repair as well as correction of velopharyngeal insufficiency in 54 patients since 1985. There were four oronasal fistulae in the 35 patients who received the procedure for primary palatal repair. These four patients were earlier cases in the series. There was no fistula in the patients operated on after July 1989. Among the 28 patients who had postoperative speech assessment, only two patients had velopharyngeal insufficiency (VPI). These unfavorable results were due to an inappropriate patient selection. For the 19 patients who received a Furlow palatoplasty for the correction of VPI, the results were also encouraging. The unfavorable results were also caused by incorrect patients selection. With increasing experience, the results of this technique should continue to improve.