The aim of this study was to assess the orthodontic treatment need and prevalence of malocclusion in 11–15-years-old Egyptian schoolchildren using the Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). A further aim was to compare the results with those from other populations matched for gender and age. The study followed the World Health Organization recommendations for oral health surveys. The sample comprised 1,464 schoolchildren (720 males and 744 females) who had not undergone orthodontic treatment, divided into two groups: 719 from 11–<13-years-old and 745 from 13–15-years-old, out of a representative sample of the school population of Mansoura Community. The IOTN results were analyzed with regard to gender using the Chi-square test. Orthodontic treatment need, using the DHC, was found in 21.5 per cent of the 11–<13-years-old and in 18.1 per cent of the 13–15-years-old; and with the AC, in 5.1 and 3.7 per cent, respectively. Considering the total sample, 19.8 and 4.4 per cent of the schoolchildren had a definite treatment need according to IOTN DHC and IOTN AC respectively. No gender dependent differences were found. It can be concluded that Egyptian orthodontic treatment need is similar to that reported in most recent studies; with approximately one in five to six children with an orthodontic treatment need.