In this report we describe three very different and interesting complications of the Le Fort I osteotomy. The first case is of a unilateral third nerve palsy developing as a result of a carotid-cavernous fistula and false aneurysm of the internal carotid artery. The second complication to be reported is total unilateral blindness. The third case is one of total avulsion of a lateral segment of the palate in a patient with a complete bilateral cleft of the primary and secondary palates. All complications were the result of a Le Fort I osteotomy performed for correction of midface hypoplasia secondary to congenital cleft lip and palate. The literature is reviewed, and the pathomechanics of each injury are hypothesized.