Cleft lip nasal deformity is a common and complex congenital craniofacial anomaly that involves multiple anatomical structures, including the nasal ala, columella, and nasal base. This deformity not only results in significant facial disfigurement but also accompanied by multiple functional impairments, such as nasal airway obstruction and oronasal fistula, severely affecting the physical and psychological well-being of patients. The complexity of the deformity poses considerable challenges for reconstruction. With the advancement of nasal anatomy, progress in imaging assessment techniques, and innovations in plastic surgical techniques, comprehensive diagnosis and treatment of cleft lip nasal deformity have achieved significant progress. This article systematically reviews the anatomical characteristics of cleft lip nasal deformity, the clinical value of preoperative non-surgical interventions in infancy, and focuses on the technical advancements in primary rhinoplasty and secondary rhinoplasty. The aim is to provide clinical practice with scientific, standardized, and personalized sequential treatment references, thereby promoting the development of cleft lip nasal deformity management.