Back ground: Dental caries and periodontal disease followed by enamel defect were the most common and widely spread diseases affecting children. Aim of this study is the assessment of the occurrence and severity of dental caries, dental plaque, gingivitis and enamel anomalies among 4-5 years old children in Karbala city-Iraq. Materials and methods: A sample of 658 children (350 males, 308 females) aged four and five years old was selected randomly from the fourteenth kindergartens in Karbala city. Diagnosis and recording of dental caries and enamel anomalies were followed the criteria of WHO 1987, WHO1997 respectively. Dental plaque was assessed using plaque index of Silness and Loe,1964. Gingival health condition was assessed using gingival index of Loe and Silness, 1963. Results: : Caries prevalence was found to be 83% of the total sample. the mean rank value of dmfs was higher among boys in comparison to girls with statistically no significant difference(P>0.05). The value of dmfs increased with age with statistically highly significant difference (p<0.01). Recording of this study demonstrated that 100% of children had dental plaque and gingival inflammation. The mean rank values of dental plaque and gingival indices for total boys were found to be higher than total girls with statistically highly significant differences (P<0.01). Positive highly significant correlations were recorded between dental caries with dental plaque and gingival indices. In general, the percentage of enamel anomalies was found to be (39.8%). The mean rank values of any type of enamel defect were found to be higher among boys than girls with statistically significant differences (P<0.05). The most prevalent type of enamel defect was found to be hypoplasia followed by diffused opacities and then demarcated opacities. Conclusion: High prevalence of dental caries and gingivitis was recorded indicating the need of public and preventive programs among kindergarten children.