ABSTRACT Aim To assess caries prevalence among 6- to 9-year-old female children in Riyadh, Kingdom of Saudi Arabia and compare between results based on nationality and age levels. Materials and methods A total of 17,891 female students from 120 public female elementary schools in Riyadh city were examined according to the World Health Organization (WHO) diagnostic criteria. The decayed [dt], missing due to caries [mt], and filled [ft] primary teeth (dmft) index and its components were measured. One-way analysis of variance (ANOVA), Student's t-test, and Chi-squared test were used to determine the significance differences, at α = 0.05. Results The overall mean [dt] for all children was 3.89 [standard deviation (SD) 3.38], which increased to 5.0 (SD 3.02) when excluding children without active caries. The mean dmft was 5.69 (SD 4.0). However, excluding children with dmft = 0, the mean dmft was raised to 6.41 (SD 3.65). The caries prevalence was 88.82%. The non-Saudi children showed slightly higher values compared with Saudi children. However, statistically, there were only significant differences in values of [dt] mean, dt = 0, and [ft] mean (p < 0.05). The dmft index was higher for 7- to 8-year-old group (5.81, SD 3.98) followed by the 8- to 9-year-old group (5.79, SD 3.79) and the 6- to 7-year-old group (5.47, SD 4.18). However, there were no statistically significant differences (p > 0.05) between 7- to 8-year-old and 8- to 9-year-old children. The 6- to 7-year-old children were statistically different from the 7- to 8 and 8- to 9-year-old children. Conclusion The dental caries prevalence among the study population was high, with the majority of children having untreated caries. This highlights the need for initiating deliberate community-based preventive measures for improvement in public health education and services provided. How to cite this article Alshiha SA, Alwayli HM, Hattan MA, Alfraih YK, Alamri AA, Aldossary MS. Prevalence of Dental Caries among Elementary School Girls in Riyadh, Kingdom of Saudi Arabia: A Cross-sectional Survey. J Oral Health Comm Dent 2017;11(2):29-33.