Relevance. Purpose of the study to assess the prevalence of malocclusion and orthodontic treatment needs among 15-year-old adolescents of the Arkhangelsk region.Materials and methods. This cross-sectional study is a part of the Third National dental examination of children and adolescents of the Russian Federation. The sample consisted of 1091 teenagers from 7 urban and 5 rural settlements. The study assessed the prevalence of malocclusion and calculated the Dental Aesthetic Index (DAI) to evaluate orthodontic treatment needs according to the sex and place of residence. The prevalence of malocclusion was presented by proportions with 95 % confidence intervals (CI) calculated by the Wilson method. Categorical variables were compared using Pearson’s chi-squared test. The numeric variables were analyzed by the Mann-Whitney test. Results. The malocclusion prevalence was 67% (95% CI: 64,2–69,8) without sex or location of residence differences. The mean DAI score was 24,0 (95% CI: 23,2–24,8) for the rural and 22,9 (22,5–23,4) for the urban adolescents (p < 0,001). 33,5 % of the 15-year-olds needed orthodontic treatment, with no differences in sex or place of residence. 18,7% of adolescents exhibited overt malocclusion, 9,7% had severe malocclusion, and 5,0% – very severe.Conclusions. The prevalence of malocclusion and orthodontic treatment needs in the Arkhangelsk region remain high. The mean DAI score was higher in rural than in urban adolescents. All the above mentioned indicates the necessity to prevent and timely treat orthodontic pathology in adolescents.