This study examined the mortality experience of children with oral clefts using the New York State Congenital Malformations Registry. Infants born in the years 1983 to 1990 to New York residents, diagnosed with an oral cleft and matched to their birth certificate were included in the analysis. Children with oral clefts were compared to a sample of live births from the years 1983 to 1990 without malformations. Children with cleft palate without additional malformations had a statistically nonsignficant adjusted risk of 1.2 when compared to children with no malformations. Children with cleft lip with or without cleft palate had a 1.1 adjusted risk. However, 35% of children with oral clefts had associated malformations and experienced much higher mortality. Children with oral clefts should be carefully evaluated for additional malformations; if none are found, their mortality appears not to be elevated.