Orofacial clefts (OFCs), encompassing cleft lip with or without palate (CL±P) and isolated cleft palate (CP), are among the most prevalent congenital craniofacial anomalies worldwide. Their etiology is multifactorial, involving complex interactions between genetic susceptibility and environmental modifiers during critical periods of embryogenesis. The development of cleft palate involves a complex interplay of genetic and environmental factors. Key regulatory genes influence neural crest cell migration and palatal fusion, while maternal exposures and health status are recognized as modulators of risk. The condition represents a significant global health burden, with prevalence varying worldwide and outcomes disproportionately severe in settings with limited access to surgical and multidisciplinary care. Advances in genomic research and registry data have refined our understanding of cleft etiology and highlighted the potential for prevention through public health measures. The management of OFCs necessitates a lifelong, multidisciplinary approach integrating surgical, orthodontic, speech, audiological, and psychosocial care to achieve optimal functional and aesthetic outcomes. This review synthesizes current evidence on the embryological, genetic, and epidemiological landscape of OFCs and outlines the principles of modern, protocol-driven multidisciplinary management, emphasizing the need for equitable access to care globally.