Aim To investigate the association between the lack of dental service utilisation and dental caries in Australian Indigenous children. Methods Data from the Longitudinal Study of Indigenous Children, which is a longitudinal population‐based cross‐sectional study in Australia were analysed. A total of 1258 children were included, consisting of the baby cohort and the child cohort at Wave 7. Logistic regression analysis was conducted to examine the association between caregiver‐reported child dental caries and dental service utilisation. Multiple imputation using the fully conditional specifications approach was used to account for missing data. Results Around one tenth (12.3%) of Indigenous children did not see a dentist when required. Lack of dental service utilisation was associated with an increased likelihood of caregiver‐reported dental caries (odds ratio (OR) 2.4; 95% confidence interval (CI) 1.5–3.8) and teeth removed due to dental caries (OR 2.3; 95% CI 1.1–4.7). These associations remained after adjusting for confounders (caregiver‐reported dental caries OR 2.3; 95% CI 1.3–3.8; teeth removed due to dental caries OR 2.1; 95% CI 1.0–4.4). The reasons reported for not utilising dental services when required were the lack of an available dentist (31.4%), difficulties with physical access (19.8%), long waiting times (13.9%), financial issues with cost (5.8%) and feeling that ‘they could cope’ (4.6%). Conclusions Lack of dental service utilisation was associated with dental caries and extraction due to caries in Australian Indigenous children.