Cleft lip and palate can often be diagnosed at birth through a comprehensive physical examination. A visible cleft in the lip or palate is usually immediately apparent at the time of birth. While detailed prenatal ultrasound during pregnancy can sometimes detect cleft lips, certain less obvious forms, such as microforms, may be challenging to identify before birth. However, after birth, a clear diagnosis can usually be made based on the infant's physical appearance.

Cleft lip and cleft palate can manifest in various ways:
* A cleft in the lip and/or roof of the mouth (palate) affecting one or both sides of the face.
* A minor indentation or notch on the lip, or a more extensive cleft extending from the lip through the upper gum and palate to the base of the nose.
* A cleft in the roof of the mouth that does not visibly affect the facial appearance.

Less commonly, a cleft may occur only in the muscles of the soft palate at the back of the mouth, covered by the oral lining (submucous cleft palate). These types of clefts are often not apparent at birth. Signs and symptoms of submucous cleft palate can include:
* Feeding difficulties
* Swallowing difficulties, potentially leading to liquids or food escaping through the nose
* A nasal-sounding voice
* Recurrent ear infections