Objective: To determine the dental caries experience and treatment needs among 5-year-olds in Albania. Research Design: This cross sectional study was conducted in 2015 by using a cluster sampling technique. The dmft was used to assess dental caries experience and caries prevalence as percentages of children with dmf>0. Caries treatment needs were assessed with dt⁄dmft x 100, missing teeth with mt⁄dmft x 100 and ft ⁄dmft x 100 as the Care Index. Participants: 2,039 five-year-olds, from 17 districts of Albania were selected. Children’s residency was divided into 3 main regions (South, West, Central and North). Method: WHO 2013 diagnostic criteria were used and dental caries was recorded at cavity level d3. Results: The mean age was 5.4 (SD 0.5) years. The caries prevalence (dmf>0) was 84.1%. The prevalence of children without cavitated lesions (d=0) was 20.1%. The mean dmft index was 4.41 (SD 3.83). The caries treatment needs were 84% (SD 26%). Conclusions: The Albanian 5-year-olds assessed in this survey had a high dental caries experience and untreated cavities in the primary dentition. The national health authorities should introduce preventive programs and improved dental care access for this age group. Key words: 5-year-old children, dmft dmf index, caries prevalence, treatments need, Albania, national survey