Purpose of review To summarize the existing literature on the international adoption of children with birth defects and identify areas for further research. Recent findings International adoption brings thousands of children to the United States each year, and children with birth defects are overrepresented in this population. Studies have demonstrated disparities in the health of children adopted from different countries as well as the complexity of medical care needed after adoption. Summary Although the health of children involved in international adoption has been well studied, there is a lack of information about the experiences of the adoptive parents of children with birth defects. We discuss a pilot study conducted on adoptive parents of children with a specific birth defect, orofacial clefting, and discuss areas for future research.