Cleft lip and palate are major public health concerns in Thailand, particularly in the north-east. The challenge for a developing country is to adapt to its unique environment the form of multidisciplinary care of patients with clefts in industrialised nations. An epidemiological study of the incidence of clefts was made by reviewing previous studies conducted in Thailand as a guide to development of a prospective multicentre study. As a result, a system for the care of patients with clefts has been developed by the Cleft Center in Khon Kaen University. The new aims of cleft care in Thailand are to establish and develop specialised cleft centres and supportive systems for interdisciplinary management, adopt protocols for long-term guidelines, provide education programmes about clefts, develop a database, and conduct relevant research projects. Other key factors in its success are the multicentre project, collaboration, fund raising, and good public relations.