Objectives:Dental caries is the most prevalent chronic condition affecting schoolchildren worldwide. This study is aimed to assess the prevalence of dental caries among schoolchildren in urban and rural districts of Sana'a governorate, Yemen, and to investigate the correlation between caries experience and level of fluoride in drinking water, age, gender, and residence.Materials and Methods:This school-based survey involved 17,599 schoolchildren (aged 6–12 years), of whom 9623 were boys and 7976 were girls. We used decay-missing-filled teeth/decay-filled teeth (DMFT/dft) indices to evaluate dental caries experience. In addition, fluoride concentration in drinking water was investigated.Results:Around 67.6% of children had dental caries. Children residing in urban districts had significantly higher mean scores of DMFT/dft than those in rural areas (P < 0.05). A significant negative correlation between caries experience and fluoride level was found (P < 0.05), with the lowest dft/DMFT scores at the optimum fluoride level of 0.61–2 ppm and the highest at two extremes, 0.0–0.4 ppm and >2 ppm.Conclusion:This survey found a very high prevalence of caries among schoolchildren in Yemen. There was also an inverse relation between dental caries experience and fluoride levels.