Five patients underwent surgery to treat velopharyngeal incompetence with an inferiorly based pharyngeal flap, and were evaluated postoperatively with a nasoendoscopy. In all patients, velopharyngeal closure occurred during speech of fricative sounds and swallowing. During speech of closed vowel sounds, patients younger than 10 years of age, compared with patients more than 20 years of age, demonstrated a grater improvement in velopharyngeal closure postoperatively. The present study supported the concept that an early pharyngoplasty should be made to obtain improved speech and articulation.