Objective: To evaluate and compare three-dimensional tooth size symmetry in the right and left sides of upper and lower dental arches in cleft lip and palate (CLP) patients and to compare it with an Angle Class I normal occlusion control group. ) and 53 individuals with Class I occlusion, all with permanent dentition, were randomly selected. Mesiodistal (MD), labiolingual (LL), and occlusogingival (OG) measurements of upper and lower teeth were recorded with a digital caliper. Descriptive statistics and paired t-test were used for statistical analysis. Results: Significant asymmetries were found between the right and left sides of the dental arches in CLP as follows: MD dimension: mandibular first premolar (ULCLP, P , .01); LL dimension: mandibular first premolar (URCLP, P , .05); OG dimension: maxillary central incisor and first premolar (ULCLP, P , .05 and P , .01, respectively), central incisor (BLCLP, P , .01), mandibular canine and first premolar (ULCLP, P , .01), and first molar (ULCLP, P , .05). Tooth crown size asymmetries were also recorded in the Class I group. Conclusions: Significant three-dimensional tooth size asymmetries were found in CLP subjects; however, such asymmetries were also present on the Class I control group. (Angle Orthod. 2014;84:623-627.)