Objective To investigate the therapeutic effect of different surgical approaches for facial cleft cyst in 68 patients. Methods Clinical data of 68 patients with facial cleft cyst was analyzed retrospectively. According to the site and size of the lesions, all the patients received surgical treatment of different approaches, including oral approach in 6, nasal endoscopic approach in 46, and labiogingival groove approach in 16. Results All the patients got cured and none recurred after followup for 13 to 19 months postoperatively. Conclusion Proper surgical approach should be chosen for facial cleft cyst according to the site and size of the lesions.