A female Newborn given birth to by a 25 years old P3+o 3alive via spontaneous vaginal delivery after 38 weeks of supervised normal pregnancy in Bingham University Teaching Hospital (BHUTH) Jos with a true Median Facial Cleft (Cranio-facial dysraphia, a Tessier type O). She was in stable state with occipitofrontal dimension of 38cm, posterior sutural dimension of 6x10cm and epicanthic distance of 15mm. She had an upper lip midline defect, absent columella and anterior nasal Septum.Cranio-facial dysraphia is rare with incidence of 1.4-4.9 per 100,000 live births. A True Median Cleft of the face, occurs due to genetic and environmental causes because of delay in the closure of the anterior neuropore. Two of the paternal cousins of the patient had cleft lip which supports a genetic predisposition. Patient had a multidisciplinary care by the obstetrician, Neonatologist, anesthesiologist and the plastic surgery team who scheduled a soft tissue repair of the upper lip defect, columella and anterior nasal septal defect. However, the patient died of febrile illness before surgeryKeywords: True Median Facial Cleft, Crano-Facial Dysraphia, ATessier Type