Background and Aim: Dental caries and malocclusion are among the most common chronic dental diseases in childhood. The aim of present study was to assess the severity of dental caries and orthodontic treatment needs and the relation between them in a sample of 10- to 12-year-old Damascus schoolchildren. Methods: This cross-sectional study included 1428 children (677 males and 751 females), all were in the late mixed dentitions and orthodontically untreated. Their dental health status was assessed using DMFT index and need for orthodontic treatment by the dental health component of the index of orthodontic treatment need (DHC-IOTN). Analytical statistics were calculated using 2-sample t-test, Chi-square, One-way ANOVA and Bonferroni tests. All the results were judged at a 95% confidence level. Results: The overall mean of DMFT was 4.4±3.2 without significant differences between males and females (p=0.705). Extreme and severe need for orthodontic treatment (grades 4 and 5 of IOTN) was registered in 341 subjects (23.88%), without significant differences between males and females (p=0.710). The severity of dental caries was significantly greater among patients with more severe grades of orthodontic treatment need. Conclusions: The DHC-IOTN index is reliable and userfriendly, which can be used for orthodontic epidemiological studies. There is significant relation between higher DMFT index and orthodontic treatment need. Therefore, early treatment and preventive national programmes is strongly advised.