Background: Limited data exist on malocclusion prevalence and orthodontic needs among Syrian refugees. This study examined 606 Syrian children/adolescents at Zaatari clinic, excluding those with prior orthodontic treatment or craniofacial anomalies. Intra- and extra-oral malocclusion features were assessed, including occlusal characteristics like crowding, spacing, and bite relationships. The Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) was also evaluated. Gender and age differences in malocclusion and IOTN grades were analyzed using chi-square and nonparametric tests.