Objective: Previous research has found lower appearance and speech satisfaction among those with cleft lip and/or palate (CL/P) compared to noncleft control groups. Less research has been conducted into which groups report the lowest satisfaction and how these two factors relate to psychosocial difficulties. This study aimed to investigate (1) differences in appearance and speech satisfaction by diagnosis and age among young people with CL/P and (2) associations between appearance and speech satisfaction and emotional and social difficulties. Design: Self-report questionnaires that had been collected between June 2016 and August 2018 within routine clinical practice were analyzed. Setting: A tertiary pediatric hospital in London. Patients: A total 130 nonsyndromic 10- and 15-year-old patients with CL/P. Main Outcome Measures: Cleft Hearing, Appearance and Speech Questionnaire; Strengths and Difficulties Questionnaire. Results: The CLP group reported significantly lower appearance satisfaction compared to the CP group (P = .005). The 15-year-olds reported significantly lower appearance satisfaction compared to the 10-year-olds (P = .008). No significant differences were found in speech satisfaction by diagnosis (P = .06) or age (P = .064). Significant negative associations were found at 15 years old between appearance satisfaction and emotional difficulties, speech satisfaction and emotional difficulties, appearance satisfaction and social difficulties, and speech satisfaction and social difficulties (P < .05 all correlations). Only the latter two associations were significant at 10 years old (P < .05). Conclusions: The findings have important implications as appearance and speech dissatisfaction may be ways in which to identify those at risk of psychosocial difficulties within clinical settings.