The aims were to estimate dental treatment needs of 15-16-year-olds in Lithuania and to relate a number of background factors such as gender, urbanization and residency to possible differences in dental treatment needs. A total of 885 adolescents in 22 randomly pre-selected areas were clinically examined. The following criteria of dental treatment needs were used: tooth with primary caries, secondary caries, tooth which needs a non-operative treatment, tooth with trauma, which needs a restorative treatment, and tooth which needs either an endodontic treatment, a crown or an extraction. Only 7.7 % of all participants had all their teeth sound. The treatment due to primary caries was the most required dental treatment modality among Lithuanian adolescents. Significantly fewer teeth required treatment due to other aforementioned reasons. Significant differences in most dental treatment needs between boys and girls were found, whereas in relation to urbanization and area of residency the differences were less pronounced.