Cleft lip and/or palate is the most common congenital craniofacial anomaly. It has been associated with numerous associated otologic conditions, including chronic otitis media, which often requires long-term outpatient antibiotic treatment. No consensus exists regarding the value of peri-operative antibiotics for the repair of the palate. This retrospective study identifies the common organisms found during pre-operative surveillance throat cultures and whether they are sensitive to the prophylactic antibiotic given perioperatively. At our institution, patients who undergo cleft palate repair routinely receive a single preoperative dose of intravenous antibiotics followed by post-operative antibiotics. This study examined the charts of 273 cleft palate patients. One hundred forty-four complete charts from those were reviewed from August 2000 to December 2004. The charts were screened for the following information: diagnosis, type of procedure, and throat culture results. Our goal is to ascertain whether the incidence of positive throat cultures warrants the need for prophylactic antibiotic use for cleft palate surgery.