This chapter provides an overview of prosthetic management of velopharyngeal dysfunction including the use of pharyngeal bulbs and palatal lifts. It includes perspectives from a pediatric dentist/orthodontist and speech-language pathologist with experience treating children with complex craniofacial conditions. Indications and contraindications for prosthetic management are discussed, patient populations are described, and standard protocols are outlined. Important considerations for device selection in addition to in-depth descriptions of evaluation procedures and ongoing assessment are included. The working relationship between the multidisciplinary team members that is integral to the success of the speech prosthesis as well as specific guidelines for holistic patient assessment and appliance fabrication is emphasized.