Head lice prevalence varies greatly between and within countries, and more knowledge is needed to approach causes of this variation. In the present study, we investigated head lice prevalence among elementary school students and their households in relation to individual and household characteristics as well as spatial variables. The investigation included households from 5 geographically separated municipalities. Present infestations among household members as well as previous infestations in the household were reported in a questionnaire. In elementary school students prevalence was low (1·63%), but more than one-third of the households (36·43%) had previously experienced pediculosis. Prevalence was higher in elementary school students than in other household members, and highest in third-grade children. Prevalence was also influenced by the school attended, which suggested that interactions between children in the same school are important for head lice transmission. Previous occurrence of head lice in homes also increased the risk of present infestation. Prevalence of previous infestations was higher in households with more children and in more densely populated municipalities, indicating that the density of hosts or groups of hosts influences transmission rates. These results demonstrate that information of hosts' spatial distribution as well as household and individual characteristics is needed to better understand head lice population dynamics.