Hypoplasia of the depressor angulae oris muscle can be detected in the crying newborn by an asymmetry of the facies, and it must be differentiated from facial palsy. Asymmetry of the facies during crying spells associated with a congenital cardiac abnormality constitutes the Cayler's cardiofacial syndrome. Nineteen cases of this syndrome are reported. A wide spectrum of congenital heart defects of varying severity was observed, ventricular septal defect being the most common along with frequent malformations involving systems and organs other than the heart.