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Background: Cover wound dressings are regarded as important postoperative care following surgical intervention. Opinions differ on whether the cleft lip repair wound should be routinely covered by dressings or not. Therefore, a well designed randomized controlled trial is required to determine if routine cover dressing offers a better outcome., Aim: The aim of this study was to compare the outcome of wound and cosmetic appearance of cleft lip repair in a randomized controlled trial between cover wound and no wound dressing groups., Materials and Methods: Forty consecutive patients requiring cleft lip repair were randomized prospectively to receive the traditional wound dressing cover (n = 20) or had the wound left exposed without any dressing cover (n = 20), after the completion of cleft wound closure. The main outcome measures were wound infection and dehiscence rates in the two groups, in addition to the scar cosmetic outcomes., Result: The two groups were comparable in terms of age and sex. The incidence of wound infection was 0% (0/20) in cover dressing group as compared to 5% (1/20) in no cover dressing group (p = 0.31). No statistical significant differences in the wound dehiscence rate between the wounds that received dressing (15%) and those with no dressing (20%) were observed. The mean diameter of scar at the 5th to 8th week review appointments was almost similar between the group with dressing (3.29 ± 1.26 mm) and no dressing (3.62 ± 1.28 mm). The patient reported outcome in relation to the cosmetic appearance of the scar after repair was similar in the two groups., Conclusion: There was no difference in the main outcome measures between the group that had cover dressing and those with exposed wound after cleft lip repair surgery. This study demonstrates that dressing of cleft repair wound may be unnecessary.