OBJECTIVE The aim of this study was to investigate the prevalence of dental caries experience among primary school children (sixth and seventh grades) in Eastern Region of the Republic of Macedonia. METHODS In this cross-sectional study, primary school children from sixth and seventh grades (N=396) were selected from 9 Central and 13 Regional Primary Schools. Participants dental status was evaluated using the 1997 World Health Organization caries diagnostic criteria for Decayed, Missing or Filled Teeth (DMFT) by 2 calibrated examiners. RESULTS The total number of children in the sample was 396, comprising 201 (50.8%) females and 195 (49.2%) males. The mean DMFT was 3.467, with standard deviation (SD) of 2.904 and 95% confidence interval (CI) of 3.180-3.754. Significant caries (SiC) index was 6.765. The prevalence of caries-free children was 21.21%. The percentage of untreated caries or the ration of D/DMFT was 0.5324 (53.24%). CONCLUSIONS Dental caries experience was seen to be high among primary school children (sixth and seventh grades) in Eastern Region of the Republic of Macedonia.