OBJECTIVE The aim was to assess the oral health status, prosthetic needs and the associated factors among older adults living in Khartoum State, Sudan. BACKGROUND Understanding the extent of the oral health problems and the associated factors in the older population is important for the determination of treatment needs and future planning of dental services. METHODS A cross-sectional study among individuals ≥60 years attending Health Care Centers. Two calibrated examiners examined participants according to the WHO oral health examination form for adults. DMFT, periodontal conditions, oral mucosal lesions, tooth wear, prosthetic status and prosthetic needs were reported. Risk indicators investigated include age, gender, socioeconomic status, general health, oral hygiene practices, tobacco use and utilisation for dental services. RESULTS Two hundred forty-nine older adults participated in the study, and 64.3% were males. The mean age was 68.4 years (SD ±6.7). The mean DMFT was 15.9 (SD ±9.1), with 85.3%, 94.8% and 19.3% of the participants having decayed, missing or filled teeth respectively. Periodontal pockets were present in 41.9%, mucosal lesions in 14.9% and tooth wear in 46.2% of the participants. Although only 5.2% were completely edentulous, 93.2% need prosthetic replacement. Risk indicators for poor oral health were being female, oral hygiene practices, frequency and reason of dental visits. CONCLUSIONS Old adults showed a high experience of missing and decayed teeth, periodontal inflammation and prosthetic treatment needs. Future oral health policies need to consider the different needs between men and women, exposure to risk factors and barriers to access dental care.