Background: Cleft palate is one of the most common craniofacial malformations which requires early surgical intervention to allow proper feeding and phonation.  Anesthesia for cleft palate surgery in infant and children carries a higher risk with general anesthesia and airway complications. Administration of opioids, often needed for intra- and postoperative analgesia, increases the risk of airway obstruction and ventilator control dysfunction. Objective: To compare the effectiveness of bilateral suprazygomatic maxillary nerve blocks (SMB) versus bilateral blocks of greater palatine, lesser palatine and nasopalatine nerves on the postoperative opioids consumption and time to first need of analgesia. Patients and methods: Three hundred and fifty child older than one year and less than five years who were scheduled for cleft palate surgery, and divided into 2 equal groups: maxillary group received standardized general anesthesia, then bilateral SMB using 0.25% bupivacaine 0.15 ml/kg with maximum dose 3mg/kg, and palatine group received standardized general anesthesia, then greater palatine, lesser palatine, and nasopalatine nerves had been blocked bilaterally using 0.5 ml bupivacaine 0.25% at each point with a total volume of 2.5 ml bupivacaine 0.25%. Postoperative rescue analgesia was administered after patient evaluation and pain assessment in the form of 100 µg/kg of nalbuphine. The two groups were compared as regard time to first analgesia given to the patient and total amount of postoperative nalbuphine consumption over the postoperative 24 hours. Also, they were compared for pain score, hemodynamic changes, block related complications, and parents' satisfaction. This study was done at Al-Azhar University Hospitals after approval of the medical ethical committee, from March 2019 till May 2021. Results: Maxillary group has less analgesic consumption with no statistically significant difference. However, the time to first rescue analgesia was significantly more in the maxillary group patients. Conclusion: SMB prolonged the duration of post-operative analgesia and decreased rescue analgesic consumption with no statistically significant difference compared to palatal block with no increases in adverse effects.