The Furlow palatoplasty technique dates to 1978 when Leonard Furlow first described his double-opposing Z-plasty technique for cleft palate repair. This technique simultaneously lengthens the palate while reconstructing the levator muscle sling. Optimizing velopharyngeal function while minimizing midfacial growth disruption and avoiding oronasal fistulae is the goal of Furlow palatoplasty. The Furlow palatoplasty technique and its modifications have been extensively used and studied for repair of all cleft types with excellent results. Patients who undergo Furlow palatoplasty repair typically have excellent speech outcomes with low rates of oronasal fistula and acceptable midfacial growth. The Furlow technique can also be used as a secondary procedure for management of velopharyngeal insufficiency.