Introduction Cleft lip and/or palate (CL/P) patients require staged multidisciplinary care, including lip and palate repair, alveolar bone grafting, orthognathic surgery, and secondary procedures such as scar revision and rhinoplasty. Delayed access to surgery and perioperative care in regional areas may impact long-term functional and aesthetic outcomes. This study investigates differences in long-term engagement and outcomes for CL/P patients in Far North Queensland (FNQ) compared with metropolitan Australia Methods A retrospective cohort study was conducted on CL/P patients treated over the past 10 years. Patients were stratified by geographic location. Data collected included age at initial lip and palate repair, timing of subsequent surgeries, perioperative complications, and engagement with multidisciplinary follow-up. Results Research is ongoing; however, preliminary findings suggest patients from FNQ experience delayed engagement with surgical care and reduced adherence to recommended perioperative follow-up. Early trends indicate lower uptake of subsequent procedures, including alveolar bone grafting, orthognathic surgery, and secondary aesthetic surgeries, compared with metropolitan patients. Perioperative complication rates appear similar, but adherence to long-term follow-up is reduced in the regional cohort Discussion Geographic barriers likely contribute to delayed intervention, reduced engagement with multidisciplinary services, and potential impacts on function and cosmetic outcomes. These trends underscore the importance of strategies to improve access, patient engagement, and coordinated care in regional populations Conclusion Preliminary findings suggest that CL/P patients in regional and remote areas face delays in surgical care and reduced engagement with subsequent procedures. Targeted interventions are needed to optimise long-term outcomes and reduce disparities between regional and metropolitan populations