The aim of this study was to determine the prevalence and association of speech disorders among operated cleft lip and palate children (CLP) in North East Malaysia. A comparative cross sectional study was performed on 98 operated CLP and 109 non cleft subjects that aged between 3-12 years old. Data collection was done clinically and also by recording speech samples of each subject from both groups using a portable cassette recorder. Results showed that the prevalence of speech abnormality was 61.2% (95% CI : 51.41-71.04) and the risk of having speech abnormality was 174.5 times (95% CI : 23.04, 1320.67; P value < 0.001) in CLP children compared to non cleft children. Therefore, it was found that children with appropriately repaired CLP in North East Malaysia failed to have normal speech.