Objective To assess the changes in hearing after rapid maxillary expansion (RME) and at the end of 6 months retention period in complete unilateral cleft lip and palate (UCLP) patients using pure tone audiometry and tympanometry test. Design Prospective pilot study. Setting Tertiary health care teaching hospital in New Delhi. Patients This study was conducted on 6 UCLP patients in the age range of 6-14 years with normal ear anatomy. All 6 patients had undergone primary repair of cleft lip and palate and required no more than 5 mm expansion in the intermolar region. Intervention RME was done using a Hyrax expander with daily activation of one-quarter turn per day for a period of 15-20 days (0.25 mm per day). Main outcome measure Audiometry and tympanometry readings at the baseline as compared to the post expansion and at the end of 6 months retention period. Results There were no significant changes in the hearing levels on the audiometry test after RME on the cleft side ( p-value −0.51) and the noncleft side ear ( p-value −0.26). No significant changes were observed in the middle ear volume on the tympanometry test after RME on the cleft side ( p-value −0.09) and the noncleft side ear ( p-value −0.28). Conclusion There was no improvement or deterioration in the hearing levels after RME and at the end of 6 months retention period in UCLP patients as evaluated using pure tone audiometry and tympanometry test. Hence RME may be undertaken in UCLP patients safely in terms of hearing is concerned.