Objectives To investigate postoperative complications in patients who underwent alveolar bone graft surgery using mandibular cortical bone (MCB) with/without particulate artificial bone (PAB). Design Retrospective study. Setting Department of Oral and Cranio-Maxillofacial Surgery in the hospital from August 2020 to August 2023. Patients Patients who underwent alveolar bone graft using MCB were reviewed. They were diagnosed with unilateral or bilateral alveolar cleft, and some of them developed postoperative complications after MCB with/without PAB repair surgery. Interventions No interventions. Main Outcome Measure(s) Complications. Results Complications occurred in 12 of 149 patients who underwent surgery (8.05%). Among these evaluated patients, 10 had surgical site infection, 8 had mucosal dehiscence, 2 had discharge of resorbable plate debris, and 6 had grafted bone necrosis. Patients with bilateral alveolar clefts were more likely to experience complications (P = 0.033). Conclusion MCB with/without PAB grafting is effective enough for patients to undergo reconstruction of the alveolar process.