Introduction– Cleft lip and palate are variations of a type of congenital deformity caused by abnormal facial development during gestation. Treatment of the condition is aimed to provide optimum function of all these organs. Apart from correction of oral competence and ear pathology, speech correction is always a challenging aspect of the management in patients of cleft palate. Various methods of palatoplasty have been described which can be categorized broadly as two layered and three layered palatoplasty or palatoplasty with and without intravelar veloplasty. Both methods have their own advantage, disadvantages and outcomes. Objective– To compare speech outcome, middle ear function, and post operative complications in palatoplasty with or without radical intravelar veloplasty (IVV). Methodology– this is a prospective observational study done on 64 patiens of complete or incomplete cleft palate. Group A (n=32) patients were operated by palatoplasty without radical IVV. Group B (n=32) patients were operated by palatoplasty with radical IVV. Results– speech outcome was improved in group B, while no significant deference was noticed in middle ear function or post operative complications. Conclusion– Palatoplasty with radical intravelar veloplasty may be considered as an effective procedure for speech outcome as compared with palatoplasty without radical intravelar veloplasty.