While MASP1 has been previously associated with 3MC syndrome and craniofacial malformations (Rooryck et al., 2011; Ashton et al., 2023), the present study documents the first association between EHHADH and craniofacial development, expanding our understanding of CL/P genetics beyond traditional developmental pathways to include peroxisomal fatty acid metabolism. The gene discussed is EHHADH; the disease is 3MC syndrome.