Purpose: The collection of comprehensive epidemiological data for dental caries of Italian schoolchildren in both rural and urban areas. Materials and Methods: The dft and DMFT indices were recorded from 27163 6-to-9-year-old children attending the primary schools of Abruzzo, a region of Central Italy, according to the World Health Organization recommendations. Results: The number of surveyed children were 5413, 8359, 8362 and 5026 in the 6-, 7-, 8- and 9-year-old groups respectively; the percentages of children positive for caries were 39.5, 48.3, 54.4 and 60.8 respectively. The mean dft (SD) values of the age groups were 1.57 (2.67), 1.79 (2.59), 1.88 (2.47) and 2.02 (2.45) respectively, with mean DMFT (SD) values of 0.07 (0.37), 0.18 (0.62), 0.37 (0.90) and 0.55 (1.09) respectively. All outcomes were significantly greater in schoolchildren living in rural areas compared with those living in urban areas, and these differences were more pronounced in the permanent dentition of the older groups. Of particular note, there was a SiC Index (DMFT) of 2.22 for the 9-year-old children living in rural areas. Conclusion: This survey initially reports the dental caries prevalence in a very large sample of Italian schoolchildren and shows that the WHO global goal for 2000 has been largely achieved in 6-year-old children, although more efforts are needed to reach the new global goal for 2015. The large differences in caries prevalence between different areas (rural and urban) and their behaviour related to the age group of the samples constitute useful findings if prevention programs are to be established in Italy. Keywords: dental caries, epidemiology, Italy, schoolchildren, urbanisation level