Abstract Background: Buccinator myomucosal flap and levator muscle repositioning is an alternative technique in the man-agement of velopharyngeal insufficiency secondary to cleft palate repair. Aim of Study: The goal of this study is to assess the effectiveness of the buccinators myomucosal flap and levator muscle repositioning in the management of velopharyngeal insufficiency secondary to cleft palate. Patients and Methods: A prospective study was done on thirty patients who have velopharyngeal insufficiency after cleft palate repair and recommended for surgery by the pho-niatrician. The period of the study was between August 2017 and August 2019. All cases were evaluated for speech assess-ment and videofluroscopy before the operation and 3 months after the operation. Successful speech outcome was defined as completely improved, improved, and not improved. Results: Overall improvement of the speech was obtained in 25 cases (83%) Nine of them (30%) were completely improved, 16 of them (53%) were improved by at least one grade, 5 cases (17%) showed no improvement. Conclusion: Buccinator myomucosal flap and levator muscle repositioning is a reliable efficient procedure for the management of VPI secondary to the cleft palate with minimal complications.