Clinical Case: Three patients, two with right and one with left cleft lip and palate, were subjected to distraction osteogenesis, before secondary bone grafting surgery, due to wide alveolar cleft. All patients are followed at the Institute of Orthodontics and Maxillo-Facial Surgery Service of Hospital Center of University of Coimbra (CHUC). Presentation of intra-oral photographs before and after procedure. Discussion: In cases of large orofacial cleft, dehiscence in the bone graft frequently occurs. The introduction of distraction osteogenesis in orthopaedic surgery has given us the ability to resolve these more extensive lip-palate clefts. As it, allows transportation of alveolar bone towards the defect and thus reduce the initial dimension of the cleft, improving the survival and the stability of the secondary graft. Conclusion: Distraction osteogenesis is a safe method and reduces the size of large cleft lip and palate, which improves the predictability of alveolar secondary bone graft surgery. Keywords: distraction osteogenesis, cleft lip and palate, bone graft, ortodontics