The authors gained fine postoperative results from closure, by tongue flap against the palatal fistula, and of a bilateral cleft lip and palate, in a case which could not be improved by two previous palatoplasties. The patient was a 20-year-old woman with a large fistula of the hard palate, measuring 25×25mm. An operation was performed to reconstruct the nasal side by mucoperiosteal flaps of the nasal septum and the nasal floor with free skin graft, and the oral side by an anteriorly based median dorsal tongue flap.