An infant whose face appears asymmetrical at rest and whose mouth is pulled downward to one side when crying is said to have an 'asymmetric crying facies' (ACF). The association of ACF with congenital cardiac anomalies is known as cardiofacial syndrome (Cayler's syndrome). The present report describes a case with cardiofacial syndrome and ACF associated other congenital anomalies, and provides criteria for differentiating absence of the depressor anguli oris muscle (DAOM) from palsy of the seventh cranial nerve and its central connections.