Purpose: This study compared nasal septum deviation (NSD), nasal deformities, and anterior nasal spine deviation (ANSD) and evaluated their relationships in patients with unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), and no cleft, using cone-beam computed tomography (CBCT). Materials and Methods: A retrospective cross-sectional study was conducted in 98 individuals (43 with UCLP, 33 with BCLP, and 22 non-cleft individuals; aged 8-36 years). CBCT measurements of NSD, nasal morphology, and ANSD were obtained. Group differences and correlations among NSD, nasal deformities, and ANSD were analyzed using 1-way analysis of variance, paired t-tests, chi-square tests, and multinomial logistic regression (P<0.05). Results: NSD was highly prevalent, affecting approximately 97% of patients with cleft lip and palate and 86% of non-cleft individuals. Cleft type was significantly related to the severity and shape classification of NSD; UCLP was associated with greater severity than BCLP, which was linked to greater severity than in non-cleft individuals.Conversely, age and sex displayed no significant relationships with NSD occurrence. Patients with UCLP exhibitedthe most pronounced nasal asymmetry and significantly greater ANSD, with deviation toward the non-cleft side consistently observed. In patients with BCLP, NSD and ANSD demonstrated a moderate to substantial positive correlation (r = 0.47), although their deviations often occurred in opposite directions. Conclusion Patients with BCLP exhibit a comparatively symmetrical nasal appearance; however, the nasolabial area remains affected. Both NSD and ANSD contribute substantially to nasal deformities in patients with cleft lip and palate, particularly those with UCLP.