BACKGROUND Optimal oral hygiene practices are instrumental to achieving good dental and gingival health. The purpose of this study was to determine the gingival health and oral hygiene practices of schoolchildren in the North West region of Cameroon. METHODS This cross-sectional survey among 12-13 years old rural and urban schoolchildren in the North West region of Cameroon was conducted between March and November, 2010. RESULTS A total of 2295 schoolchildren were interviewed but only 2287 of them had oral examination giving a 99.7% participation rate. Out of 2287 school children examined, 1676 (73.3%) had normal gingiva while 26.7% had gingivitis of varying severity. The gingivitis was found significantly more in rural dwellers (P = 0.001). In terms of the severity of the recorded gingivitis, mild gingivitis constituted 549 (89.9 %), moderate gingivitis 49 (8.0%) and severe gingivitis 13 (2.1%). The majority-1929 (85.4%) of the participants had received instruction on how to care for their teeth and the predominant source of this instruction was from their parents. Irregular teeth cleaning were marked 1137 (49.7%) among the children. The dominant teeth cleaning materials were toothbrush and toothpaste. The other oral hygiene aid utilized by the participants include dental floss-25 (1.1%), stick-759 (33.6%), dental floss-25 (1.1%) and other unorthodox agents. The reasons for teeth cleaning among the participants in descending order were to make the teeth clean, to prevent halitosis, to make teeth stronger, to prevent pain and dental diseases. CONCLUSIONS The prevalence of gingivitis among Cameroonian schoolchildren in the Northwest region was 26.7% with majority being of mild gingivitis category. Parents, dental professionals and teachers were the main sources of instruction on oral care.