Introduction
Asymmetric crying face (ACF) is a minor anomaly where in one side of the mouth does not descend during crying. A congenital asymmetric crying face is caused by congenital hypoplasia or agenesis of the depressor anguli oris muscle on one side of the mouth. Asymmetric crying face (ACF) is a minor anomaly found in 3–8 per 1,000 births, which may be associated with other anomalies. This association has been reported in 20–70% of cases, most commonly in the cardiovascular system (44%) and less frequently involving the genitourinary, musculoskeletal, cervicofacial, respiratory, and, rarely, the endocrine system.

 Case I
A 12 month-old female child presented with cyanosis and recurrent respiratory tract infections. Asymmetric facies on crying had been noticed since birth. Examination and echo findings revealed tetralogy of fallot. There was a depression of the lefy angle of the mounth.

 Case II
            A 10 month-old female child presented with cleft palate. During a routine physical examination, asymmetric crying face was noticed; the left corner of the mouth drew right and downward, while the left corner did not move when the baby cried. Forehead wrinkling, eye closure, and nasolabial fold depth remain intact and equal on both sides. These findings differentiate this disorder from a facial nerve palsy. Veau Wardill Kilner palatoplasty was performed. There were no intraoperative or postoperative complications and no relapse was observed in 16 months of follow up.
Discussion
            Asymmetric crying facies (ACF) is a minor congenital anomaly seen in newborns. It is caused by either agenesis or hypoplasia of the depressor anguli oris muscle. This unilateral facial weakness is first noticed when the infant cries or smiles, affecting only one corner of the mouth, i.e., lower lip, and occurs on the left side in nearly 80% of cases. The face appears symmetric at rest, but the mouth is pulled downward to one side when crying. Asymmetric crying facies is a minor isolated finding in most cases; however the interesting aspect of this abnormality is the association with other major congenital anomalies.       
Hence all newborns should be carefully examined for this subtle facial sign and if found, a search for other anomalies should be performed. In addition, a multidisciplinary team should follow these patients, with screening for complications and appropriate management.