The treatment modality of cleft palate has been progressed with benefits of safe anesthesia, reliable blood control and etiological, anatomic understanding. The purpose of this article is to review historical advancement in order to applicate proper surgical methods to cleft palate patients. More than 36 English written articles with 4 related books were reviewed chronogically from earlier work to contemporary achievements. The efforts to treat deformity in cleft palate patients have developed from simple closure of fistula to various modifications which have functional consideration of musculature, speech, growth. There had been debates to reach consensus of the adequate age to undergo cleft palate surgery. Understanding of historical progress from humble try to artistic work would help us to reconstruct cleft palate patient more systemically and properly. We can take advantage of this study to educate or to help foreign medical services. For the better understanding of cleft palate management as a routine reconstructive procedure, the various historical treatment trends based on surgical approaches were reviewed and summarized in this article.