Objective: To determine the dental caries experience and treatment needs among 12-year-olds in Albania. Research design: This 2011 cross sectional survey used cluster sampling with DMFT and SiC indexes used to assess dental caries experience; DT/DMFT to assess untreated caries; FT/DMFT the care index and MT/ DMFT as missing index. Participants: 1928 12-year-olds selected from state schools across 16 local districts with a mix of urban and rural areas and contrasting socio-economic groups. Method: WHO protocols were used. Results: The caries prevalence (DMFT>0) was 87% (95%CI 85.6,88.4) and 29.6% were without cavitated carious lesions (DT=0). The mean caries experience (DMFT) was 3.73 (sd 2.71) for boys , 3.71 (sd 2.61, p=0.88) for girls and 3.72 (sd 2.66) overall. The caries treatment needs DT/DMFT was 56% (sd 0.36), the mean FT/DMFT (Care Index) was 31% (sd 0.34) and the mean SiC index was 6.72 (sd 1.92). Conclusions: Dental caries experience and untreated dental caries were high compared with 12-year-olds in most European Union Member States. This suggests an urgent need for a national preventive program and improved access to oral care for this age group. Key words: dental caries, DMF index, caries prevalence, dental treatment needs