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Median cleft of the lower lip & mandible (Tessier no. 30 facial cleft) is an uncommon condition. This cleft varies in severity, in mildest form it may present as submucosal notching of lower lip & in most severe form it may involve lower lip, tongue, alveolus, mandible, floor of the mouth and neck structures. In our case report, we describe a child patient having median cleft of the lower lip with ankyloglossia, and its treatment. Keywords: Median, Cleft, Lower lip, Mandible, Ankyloglossia, Tessier cleft 30