Maxillary retrusion is defined as inadequate maxillary development. In addition to aestetic problems, sagittal skeletal deficiencies of maxilla can cause functional problems such as breathing and feeding difficulties and often requires surgical treatment. There are a number of limitations of conventional surgical treatment of severe maxillary hypoplasia. Today, treatment of maxillary retrusion with external distraction is a widely applied technique. The purpose of this review is to evaluate the studies which report the long term stability of treatment results obtained with external distraction in cases with cleft lip palate and/or craniofacial syndrome and to distinguish the possible factors affecting the treatment stability.