Dental fluorosis is caused by excessive fluorine intake during tooth development. Aim The aim of this study is to assess the prevalence of dental fluorosis among children in the Republic of North Macedonia. Method The investigation was conducted on a group of 1,591 school children, aged 6, 12, and 15 years, of both genders. Among the participants, 313( 19.67%) were 6 years old, 641(40.29%) were 12 years old, and 637(40.04%) were 15 years old. The dental fluorosis status of the participants was evaluated using the 2013 World Health Organization diagnostic criteria. Initially, the frontal permanent teeth were clinically examined, and if suspicious changes were detected, the permanent molars were also examined. Any participant exhibiting any degree of dental fluorosis was photographed using a Sony Cyber-shot DSC-P73 digital camera. The Statistical Package for Social Science (SPSS), version 20, was used for data management and analysis. Kruskal-Wallis test was used to compare the difference between the concentration of fluorine in drinking water and the severity of dental fluorosis. Statistical significance for all statistical procedures was set at ≤ 0.05. Results: Dental fluorosis of the first, second, and third degree was observed in 51 children who had been lifelong residents of settlements with higher concentrations of fluoride in drinking water. Five of these children, aged 6, were from the villages of Monospitovo and Gradsko. Forty children, aged 12, were from the villages of Monospitovo, Viničani, and Gradsko, and 6 children, aged 15, were from the village of Viničani. Conclusion: Dental fluorosis among children in the Republic of North Macedonia has a low prevalence.