A collaborative project was undertaken between the Orthodontic Department- Cairo University and the Ministry of Health to investigate the birth incidence of cleft lip and/or palate patients in the Arab Republic of Egypt from the 1st of January to the 31th of December 2013. This study represented a part of the project and aimed to determine the incidence of cleft defects in Alexandria, El-Beheira, Al-Fayoum and Red Sea Governorates. To ensure precise data collection, primary health care facilities, main governmental hospitals of the Ministry of Health, University hospitals, main health offices and Smile Train treatment centers were selected, as reliable sources of gathering data in the assigned governorates. All newly born babies included in the study were born to Egyptian parents. Still births and abortuses affected by clefts were not included. In this study, Shapira et al classification was selected due to its reliability, efficiency and simplicity since it was found to be easier for the health care staff to apply. Diagnostic sheets were distributed among the selected areas, containing full data about each cleft case. Cases were diagnosed and recorded in the diagrammatic sheet by the health care staff and was double checked by the candidate. Parents were instructed on how to feed and give care for their babies and they were referred for follow up with the cleft lip and/or palate team at the Orthodontic Department, Cairo University for pre-surgical orthopedic correction if needed (nasoalveolar molding and feeding plates), then they were referred for the surgery needed at the proper time following the planned cleft lip and/or palate management protocol (Appendix IV).The collected data were statistically analyzed and the following conclusions could be drawn:1.The mean incidence value of Cleft Lip and/or Palate in the four Egyptian studied governorates was 0.40/1000. However, this incidence value varied insignificantly between 0.50/1000 in Red Sea, in Alexandria 0.47/1000, in El- Beheira and Al-Fayoum 0.40 and 0.39/1000 respectively. 2.Cleft lip and/or palate defects were dominant in males than females. However, this sex difference was only significant in Alexandria.3.The cleft type varied insignificantly between the studied governorates, the most prevalent type was the cleft lip and palate followed by the cleft lip and the least type was the isolated cleft palate.4.The unilateral Cleft Lip and/or Palate showed higher significant percentage (76%-98%) than bilateral clefts (11%-24%) in all the studied governorates.5.The left sided clefts represented insignificantly higher percentage (71.4% - 100%) than right sided in all the studied governorates except in Al-Fayoum ,where the right sided was higher insignificantly than the left sided.The most significant etiological risk factor was the maternal passive intake in all the four studied governorates. Moreover, it was followed by medicine intake and consanguineous marriage.