The 2001 Austrian oral health survey investigated a representative sample of 6-year-old Austrian children. 516 6-year-old Austrian children were investigated with respect to d1-3mft and d1-3mfs and visible plaque index (VPI). Forty-nine per cent of the children were caries free (d3ft = 0). The children had 2.1 d3ft (3.5 d1-3mft) and 3.9 d3fs (6.1 d1-3fs). 2.6 d3s unrestored carious lesions (d3s) predominated over 1.3 filled surfaces (fs). There was no statistical difference between girls and boys. The prevalence of caries showed a very skewed distribution: 50% of all d3s were concentrated in 8% of the children with 86% of all carious lesions in 25% of the children. The prevalence of caries was inversely related to the educational level of the parents (Spearman rank test p 0.001; r = -0.219) and family income (p 0.001; r = -0.173): Children of parents with low educational levels (9 years of schooling) had 3.3 d3ft whereas children of parents with university degrees had only 1.0 d3ft. Six-year-old Austrian children showed a very skewed distribution of the prevalence of caries and high need for dental treatment. There is a great need for pediatric dentistry in Austria. Keywords: caries prevalence, dmf, dental care, preschool children