OBJECTIVE: To determine the prevalence of treatment of early childhood caries (ECC) using general anesthesia (GA) in children with cleft lip and/or palate (CL/P). DESIGN: Retrospective chart review of children followed by the Manitoba Cleft Lip and Palate Program (MCLPP) to determine the frequency of treatment for ECC under GA. SETTING: Children's Hospital, Winnipeg, Canada (a tertiary care centre). PATIENTS: Children registered with MCLPP between January 1, 2008- December 31, 2019. INTERVENTIONS: The chart review collected data on the following variables: sex, date of birth, postal code, type of cleft, whether child had treatment of ECC using GA, age at the time of GA, and cost of treatment. MAIN OUTCOME MEASURES: Association of CL/P with ECC. RESULTS: Overall, 441 children had CL/P. 17% had isolated cleft lip (CL), 46% had isolated cleft palate (CP), and 37% had both cleft lip and palate (CLP). Overall, 24.3% of children with CL/P underwent dental surgery using GA while 14.5% underwent dental surgery to treat ECC between 12-59 months of age. When compared to a reference of Canadian healthy children 12-59 months of age, a child with CL/P was 15 times more likely to require GA to treat ECC. CONCLUSION: Treatment for caries under GA in children with CL/P is common. In the children with CL/P the rates of GA for treatment of ECC are significantly higher when compared to the general population. Children with CL/P require comprehensive oral health prevention to reduce the risk for caries and the need for treatment under GA.