This chapter reviews the impact of cleft palate and velopharyngeal dysfunction (VPD) on psychosocial adjustment and quality of life. Individuals with cleft palate and/or VPD are vulnerable to emotional and behavioral problems, social difficulties including stigmatization and bullying, as well as impairments in quality of life. Strategies for addressing psychosocial risks within the context of interdisciplinary care are reviewed, including offering patient and family education and social support resources, conducting routine risk screenings, and connecting patients and/or families to evidence-based psychological interventions. The chapter concludes with recommendations for future research.