This report chronicles the case of an adolescent female with cleft palate associated severe hypoplastic maxillary Class III deformity. Treatment involved anterior maxillary segmental distraction osteogenesis (AMSDO) in conjunction with pre-distraction and post-distraction orthodontics. Following pre-distraction orthodontics, AMSDO was performed using a customized Hyrax distractor assembly. Post-distraction orthodontics helped stabilize distraction outcomes and finalize occlusion. Post-treatment, midface deficiency and prognathic profile improved dramatically with establishment of acceptable interincisal relationship and well-balanced functionally interdigitated occlusion. Three-year follow-up showed excellent morphologic and functional stability. AMSDO is a viable modality that contributes to effective stomatological rehabilitation of patients with cleft maxillary hypoplasia.