OBJECTIVE: To describe the case of a patient with cleft palate with complaints of dysphonia associated with vocal nodules, who presented at Santa Casa Hospital in Porto Alegre city. CASE REPORT: LB, a39-year-old female was engaged in a program of speech therapy due to vocal complaints. An otorhinolaryngologist had found a nodule on her right vocal fold. The patient also reported late corrections of a cleft palate. The assessment revealed a misarticulation, incorrect positioning of the tongue during the production of speech sounds, hypernasality and hearing loss. Cleft palates are congenital deformities classified among the group of dysplasias, which are characterized by errors of fusion of embryonic facial processes. Individuals with cleft palates present with altered stomatognathic function. A speech therapist can work to address these issues. L.B. reported that people have difficulty understanding when she speaks, and complained of vocal fatigue. After a thorough assessment of her phonological issues, a speech therapy program was tailored to her particular voice complaints, with attention to her orofacial myology and pneumo-phono-articulatory coordination. CONCLUSION: Early participation in a program of speech therapy can address issues related to incorrect development of the stomatognathic system. In cases such as this, when participation in such a program is delayed, sensory-motor-oral issues may be slower to improve. After 4 sessions of therapy, the patient exhibited improvement in all aspects of vocal production and articulation.