Comparison of the outcome of treatment of patients with clefts of the lip and palate can yield valuable pointers for discriminating between beneficial and harmful procedures. The development of a standardized rating scheme to assess the facial appearance of these patients is described. The rating scheme can be used in conjunction with conventional cephalometric analysis and dental arch evaluation. A method is described in which the nasolabial area is masked, thus reducing the influence of the surrounding facial features since it is shown that judges are influenced by general facial attractiveness. An ordinal scale has been evaluated in which four features of the nose and lip are assessed separately and in total by a panel of judges. The nasolabial profile, the nasal symmetry, the nasal form, and vermilion border were assessed using a 5-point scale. Acceptable pooled levels of reliability and reproducibility were obtained. This standardized rating system may be used to differentiate treatment outcome in patients from different treatment centers.