Oral-facial-digital syndromes are a group of disorders with various subtypes. Type V, also known as the Thurston syndrome, is an autosomal recessive condition characterized by median cleft of the upper lip, postaxial polydactyly of hands and feet, and oral manifestations. Majority of the cases reported in the literature have been of Indian ethnic origin. We report a case of a possible variation of this syndrome in a 5-month-old Indian girl who presented with severe midline clefting, cleft palate, and atypically, preaxial polydactyly of the right hand.