Background and Aims: Investigation of the most common and most important diagnostic-therapeutic needs of patients within a healthcare system is pivotal for effective planning and policymaking. This study aimed to examine the dental treatment needs of 7-12-years-old students of Babol, Iran. Materials and Methods: This retrospective study involved 729 students (264 girls and 465 boys) from elementary schools of Babol, Iran, who were actively attending school during the academic year 2015-2016. Information concerning the dental treatment needs of students was extracted from forms containing oral and dental examination data, as regulated by the Ministry of Health. The data were then subjected to statistical analysis using SPSS version 26 software by Chi-square test at significance level of 0. 05. Result: The prevalence of dental decay among students aged 7 to 12 in Babol city was 93. 5%. The most treatment needs were pulp therapy (517 students, 70%), restorative treatment (481 students, 66%), and fissure sealant (422 students, 58%), respectively. For permanent first molars, the highest therapeutic needs were fissure sealant (402 students, 55%) followed by restorative treatment (365 students, 50%). Notably, the frequency of the need for pulp therapy in the 7-9 age group exceeded that in the 10-12 age group (p<0. 001), and there was a higher frequency of scaling needs among boys compared to girls (p<0. 001). Conclusion: Almost all students needed dental treatments, and among them, the most needed treatment was the need for pulp therapy. Approximately half of the students required at least one restoration for a permanent first molar. These findings underscore a notable prevalence and severity of dental decay in both primary and permanent teeth among students in Babol city.