A pilot study collecting data both retrospectively and prospectively covering a span of 4 years (January 1989 to December 1992) was carried out at King Fahd Specialist Hospital, Al-Gassim, Saudi Arabia. The aim was to study the epidemiology of facial clefts in the exclusively Saudi population. A total of 137 cases were studied. This study gives the highest reported incidence of clefts (2.19 per 1000 live births) with some distinct differences in the pattern of clefts as compared to other documented studies.