Purpose: To determine the prevalence and pattern of dental caries among public primary school children in Lagos State, Nigeria. Materials and Methods: A cross-sectional survey of pupils in randomly selected public primary schools in Lagos State Nigeria was conducted. Dental examinations were carried out on 2835 children and caries diagnosis was based on the WHO diagnostic criteria (1999). Results: Overall caries prevalence in the study population was 13.1% with the highest caries prevalence recorded among eight-year-old children (17.7%), boys (13.5%) and those of the Hausa tribe (15.0%). The DMFT score ranged between 0 and 11 with a mean score and standard deviation of 0.344 ± 0.937. Children aged 5-10 years had slightly higher caries prevalence (14.8%) than those aged 11-16 years (10.6%). The first molars were the worst affected teeth in both the deciduous and permanent dentitions. The mandibular left first molar had the highest caries prevalence (4.7%) in the deciduous dentition, while the right mandibular first molar had the highest tooth-specific caries prevalence (3.5%) in the permanent dentition. The restorative index for the study population was 0.3% while the treatment index was 5.7%. Conclusion: While the caries prevalence in the study population is very low, the treatment and restorative indices are unacceptably low. There is a need for early preventive strategies and treatment services in terms of restorative care for this important age group. Keywords: dental caries, prevention, school children, treatment needs