Introduction: The purpose of this study was to determine the incidence of cleft lip and/or palatedefects in Giza, Matrouh, Minya And Qalyubia Governorates in the Arab Republic of Egypt. Methods: Before the initiation of the project, the Ministry of Health endorsed the maternity staff members which included the doctors and the nursing staff who will be participating in the program from every governorate to attend a one day course in the Faculty of oral and dental medicine – Cairo University. At the end of that day, a small test was given to evaluate the ability of the staff to diagnose the cleft cases. Handouts and CDs were distributed for each participant to be as a resource or reference for any missing information. Diagnostic files containing ten diagnostic sheets and the diagrammatic representation of the classification of CL±P were provided for each medical unit, health care facility and main governmental hospital, each sheet having a sequential serial number for registering personal, familial, medical history and any predisposing factors for each newly born cleft baby. Data was monitored and collected monthly from all medical units and health care facilities in each governorate till the end of the year 2013. The incidence data was collected based on the number of births born in each city district in the governorate and calculated over the whole year. At the end of the year, Microsoft Office 2013 (Excel) and Statistical Package for Social Science (SPSS) version 20 was used. Results: A total incidence of 0.46/1000 of cleft defects was found in the four governorates. The highest incidence of cleft defects was found in Marsa Matrouh 0.78/1000 and Giza 0.64/1000 governorates compared to the remaining governorates. There was statistically significant difference in the incidence of cleft defects between the three governorates. The most significant etiological risk factor was maternal passive smoking in the four studied governorates.