Objective: To investigate the retention rate and anticaries effects of pit and fissure sealant in the first permanent after 5 years among children in Henan Province. Methods: Random cluster sampling was used in 8 counties/districts of Henan Province that participated in the comprehensive intervention program for children s oral diseases in 2015. One project school was selected from each county, and two classes of sixth grade students were selected from each school. In the selected class, children who underwent pit and fissure sealing in the first permanent molars in 2015 were treated as the experimental group, and children who met the indications but did not undergo pit and fissure sealing were treated as the control group. The retention of sealant and caries in the first permanent molars were investigated. Results: After 5 years of pit and fissure sealing, the complete retention rate, partial retention rate and complete abscission rate were 15.84%, 55.32% and 28.84%, respectively. The incidence of caries in the experimental group (19.02%, 0.44±0.87) was lower than that in the control group (27.91%, 0.54±1.00) ( χ 2/t =11.98, 2.63, P <0.05). The caries reduction rate was 31.85%. The rate of net benefit was 8.59%. The higher the retention rate of sealant, the lower the incidence of caries ( χ 2=167.16, P <0.01). Conclusion The long term effect of the comprehensive intervention project on children s oral diseases in Henan Province is promising. Pit and fissure sealant can effectively prevent caries in children s first permanent molars.