Background: Limited research has been undertaken in Australia to assess the dental status of pre-school Aboriginal children. This cross-sectional study records the number of decayed, missing and filled teeth (dmft) and surfaces (dmfs) of pre-school Aboriginal children living in different locations in New South Wales (NSW), Australia. Methods: A convenience sample of young children from seven Aboriginal communities in rural, remote and metropolitan areas of NSW, was recruited. One calibrated examiner recorded the dmft/s of children with written parental consent. Results: 196 children were invited to participate and 173 children aged two to five years were examined, a response rate of 88.3 %. Forty percent (n = 69) of the children were diagnosed with dental caries with a mean of 2.1 (SD = 3.6). The dmft scores were significantly higher in remote locations when compared to rural (p = <0.0001) and metropolitan areas (p = 0.0155). Children 4-5 years old living in remote NSW had a mean dmft of 3.5 and mean dmfs of 8.0 compared with children living in rural areas who had a dmft and dmfs of 1.5 and 4.2 respectively. Untreated dental caries was the primary contributor to the scores, and children who had previously received dental treatment still had active carious lesions. Conclusion: There was a high prevalence of untreated dental caries among the Aboriginal children, particularly for those in remote locations.