Oral clefts are being diagnosed prenatally more frequently. When informing future parents on outcome and prognosis, the category of cleft as well as the presence of other structural congenital anomalies is crucial. Especially the identification of an underlying chromosomal defect will influence prenatal counselling and management of the pregnancy significantly. To provide a basis for prenatal counselling and allow informed decisions on invasive prenatal diagnostics, this systematic review summarises literature on prenatal and postnatal findings of associated anomalies and chromosomal defects related to cleft category. Based on these findings, specific clinical advise—including whether to offer conventional karyotyping or array-based methods—are presented according to cleft category. (By Dr. AM Rozendaal, http://jmg.bmj.com/content/49/8/490.abstract?etoc )