Purpose: The aim of the present study was to investigate the malocclusion status and treatment needs of adolescents with cleft lip and/or palate aged between 12 and 18 years, and to compare them with those of non-cleft subjects. Materials and Methods: A cross-sectional survey was conducted at the Outpatient Department, Plastic and Reconstructive Surgery, KLE's Hospital and Medical Research Centre, Belgaum, India, during the period March to September 2004. The sample comprised 56 cleft lip and/or palate subjects aged between 12 and 18 years who were matched with 168 non-cleft subjects (controls) selected from the general population. The clinical examination was conducted using methods recommended by the World Health Organization oral health surveys. The Dental Aesthetic Index (DAI) was used to record the data. Results: About 37.5% of cleft lip and/or palate subjects and 60.71% of controls scored a DAI u 25 (no abnormality or minor malocclusion). About 51.78% of cleft lip and/or palate subjects and approximately one-third of controls (35.71%) scored a DAI of 26 to 30 (definite malocclusion). Subjects with cleft lip and/or palate disorder (8.92%) and controls (2.97%) scored a DAI of 31 to 35 (severe malocclusion, P = 0.06). Subjects with cleft lip and/or palate disorder (1.78%) and controls ( 1%) scored a DAI v 36 (handicapping malocclusion). Conclusions: A majority of the cleft lip and/or palate subjects exhibited severe malocclusion, and treatment was highly desirable when compared to non-cleft subjects. Keywords: cleft lip, cleft palate, Dental Aesthetic Index, malocclusion, treatment needs