Background: Children with disabilities experience long-term impairments in one or more developmental domains, including cognitive, communicative, motor, behavioral, sensory, and self-care functions, often requiring continuous support in daily life. These children are particularly vulnerable to poor oral health due to a combination of factors such as limited motor coordination, dependence on caregivers, longterm medication use, and unfavorable dietary patterns. Consequently, they are at increased risk for dental caries, periodontal diseases, and oral infections. In Mongolia, oral health disparities among children with disabilities remain insufficiently explored, and evidence-based data on their treatment needs are limited. Addressing this gap is essential for planning targeted preventive and therapeutic strategies. Aim: To evaluate the oral health status and determine the dental treatment needs of children with disabilities in Ulaanbaatar, Mongolia. Materials and Methods: A descriptive cross-sectional study was conducted among 888 children with disabilities attending special education schools in Ulaanbaatar. Oral examinations were performed following ethical approval (No. 2023/3-06) from the Research Ethics Committee of the Mongolian National University of Medical Sciences. Dental caries was assessed using dmft/DMFT indices, and oral hygiene status was evaluated using a plaque index. Data were analyzed using Stata 16.0, with statistical significance set at p<0.05. Result: The overall prevalence of dental caries was 85.5%, indicating a substantial disease burden. Caries prevalence and mean experience were 66.7% and 5.28±4.58 (dmft) in primary dentition, 86.2% and 5.23±3.75 (DMFT + dmft) in mixed dentition, and 83.6% and 5.44±4.00 (DMFT) in permanent dentition. Oral hygiene assessment showed that only 9.8% of children had good hygiene, whereas 46.3% exhibited poor oral hygiene, which was consistently associated with higher caries levels across diagnostic groups. Notably, 83.3% of children had at least one untreated decayed tooth or caries-related complication, reflecting a considerable unmet treatment need. Conclusion 1. The prevalence of dental caries among children with disabilities in Ulaanbaatar was 85.5%. Specifically, during the primary dentition stage, the prevalence was 66.7% with a mean caries experience of 5.28±4.58 (dmft). In the mixed dentition stage, the prevalence increased to 86.2% with a mean caries experience of 5.23±3.75 (DMFT+dmft). During the permanent dentition stage, the prevalence was 83.6%, with a mean DMFT score of 5.44±4.00. 2. Assessment of oral hygiene status using the plaque index revealed that 9.8% of the children had “Good” oral hygiene, 43.9% had “Fair” hygiene, and 46.3% had “Poor” oral hygiene. 3. The caries profile was predominantly characterized by untreated decayed teeth, and a strong direct association was observed between dental caries and oral hygiene status. Overall, 83.3% of the children required oral healthcare services and treatment, with the highest needs observed among those with permanent dentition, males, and children with intellectual disabilities.