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El orfanato telah diterima dengan baik oleh pengkritik Amerika pada pengeluaran yang terdahulunya. Laman web penempatan filem Rotten Tomatoes melaporkan bahawa 86% dari pengkritik telah memberikan filem review positif, berasaskan pada suatu sampel 146. At Metacritic, which assigns a normalized rating out of 100 to reviews from mainstream critics, the film has received an average score of 74, based on 33 reviews. Critics praised the film for its lack of cheap scares. Film critic for the Chicago Sun Times Roger Ebert praised the film claiming it to be "deliberately aimed at viewers with developed attention spans. It lingers to create atmosphere, a sense of place, a sympathy with the characters, instead of rushing into cheap thrills". Bill Goodykoontz of the Arizona Republic echoed this statement noting, "Bayona never lets The Orphanage descend into cheap horror. The scares here are expertly done and, placed in the context of Laura's state of mind, well-earned, perhaps even explainable (or not)." Peter Howell of the Toronto Star wrote, "The year's best horror picture is also one of the simplest. The Orphanage makes little if any use of digital tricks to present its numerous terrors." The casting of Chaplin and Rueda was praised while the role of Carlos was called dull. Goodykoontz noted the role of Carlos, saying "Cayo is rather pedestrian as Carlos, but he isn't given that much to do". Michael Phillips of the Chicago Tribune shared this opinion saying, "Rueda has a great pair of peepers for this assignment. When she looks one way and then the other, while skulking through the hallways of her childhood home, every nerve-wracking whatwasthat? registers, and how. Cayo is pretty dull by comparison, but Chaplin certainly is not." Liam Lacey of The Globe & Mail praised Rueda stating, "The strongest appeal of the film is the brooding, intense performance by Spanish actress, Belen Rueda." The Orphanage listed as one of the top 10 best films of 2007 by several critics, including Lawrence Toppman of the Charlotte Observer, Marc Doyle of Metacritic and Tasha Robinson of The Onion. Anthony Lane of The New Yorker included the film on his top ten list of 2008.

There were few negative reviews, and those that were negative were not in agreement. A negative review came from Lacey of The Globe & Mail, who felt that at "[the film's] core, it seems intended as a sympathetic drama of a bereaved mother, who may have slipped into madness. What's even more disquieting is the persistent undercurrent of exploitation - the mixture of grief and jarring shock effects and the pitiless use of a disfigured child as a source of horror." A.O. Scott of The New York Times claimed to the film to be a "diverting, overwrought ghost story" and that it "relies on basic and durable horror movie techniques". Jack Matthews of The New York Daily News founding the ending of the film to be one of the worst of the season, but praised the acting of Belén Rueda.