Objectives: The aim of this study was to evaluate the dental health condition of the first permanent molars in group of rural and urban Egyptian school children (9-12) years old using: DMF value to know dental health condition of these first permanent molars and Care index for the first permanent molar for evaluation of the percentage of the treatment done for these molars.Subject and Method: The study was carried out on 9- 12 years-old students in six primary governmental schools in Egypt. According to the area of residence, they classified into two groups: 1000 students from urban area (Abdeen district in Cairo governorate) and 1000 from rural area (Osim village in Giza governorate), each group was divided into four subgroups with 250 students for each age group 9, 10, 11, 12 years old. All students were examined clinically for dental caries using World Health Organization (WHO) criteria to calculated DMFT and treatment need of the first permanent molars. Diagnostic chart was designed by the authors for this study including questions about: age, gender, socioeconomic status, medical history, dental history, oral hygiene measures and eating habits. Data were collected and statistically analyzed.Results: The mean DMFT of first permanent molars was 1.02±1.08 for rural area and 1.08±1.42 for urban area; it was increases with age and with no significant difference between boys and girls in rural area while in urban area the girls were significantly higher than boys. The mean Care index of first permanent molars was 1.9±1.55 for rural area and 9.8±5.03 for urban area; it was increases with age and with no significant difference between boys and girls.Conclusion: The mean DMFT of the first permanent molar of the students in the current study was found to be higher in both rural and urban areas. The mean Care index of the first permanent molars was found to be higher in the students of urban area compared to students of rural area. It is recommended that there should be preventive programs to improve student’s oral hygiene habits and knowledge which could prevent dental caries later on in their lives.