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Aim: The aim of the cross-sectional study was to ascertain the oral health status and treatment needs of special health care need children of age group 3-16 years in rural and urban areas of Hyderabad, Telangana, India., Materials and Method: To assess and compare the caries status, oral health status, oral hygiene measures, diet and treatment needs in rural and urban population. The data collected was processed and analyzed using the SPSS statistical software program., Results: Among 1000 subjects in rural and urban population highly significant difference was observed for Oral hygiene aids ( P < 0.003) and for DMFT ( P < 0.008) and no significant difference for dmft ( P > 0.26). OHIs status showed no difference in primary and permanent in both rural and urban population ( P > 1). Filled and missed were in DMFT, dmft was very low even though there were carious tooth in study population. Most of the children in rural and urban population required varied treatment needs like oral prophylaxis, restoration, pulp therapy, crowns and extractions., Conclusion: High prevalence of dental caries and the need for restorative care was noted in these children emphasizing the necessity of change of attitude towards oral health and improved oral care by repeated counselling of parents by primary health care physicians., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)