In everyday clinical practice, most treatment decisions are based on orthodontic treatment need indices. Several indices have been developed to assess orthodontic treatment need in particular populations or communities. One of the most widely applied indices for assessment orthodontic treatment need is the Index of Orthodontic Treatment Need (IOTN). Demand for orthodontic therapy may be influenced by the patient’s perceived need for treatment and the anticipated improvement in self-image. Lew has stated that the practitioners should focus their attention beyond orthodontic mechanotherapy to the most subjective aspects of patient’s discomfort and attitude toward treatment. Aim: The aim of present study is to determine the prevalence of malocclusion and the need for orthodontic treatment in adolescent school children of Tripura. Methodology: The study was conducted from june 2017 to august 2018. Five schools were randomly selected in the state Tripura (North East) and a random sample of 1500 children aged 12 to 18 years old were screened. School authorities and parents of sampled children was notified about purpose of the study conducted. Result: The preventive & interceptive strategies and early orthodontic treatment as adopted in other countries, could be successfully integrated in the development of an effective national programe in Tripura aimed at increasing the level of oral health and reducing malocclusion risk factors. Conclusion: The findings could be explained considering the very hard social and economic conditions in which these populations live. On the other hand, the lower prevalence rate for definite orthodontic need reported in the mentioned epidemiological European surveys on adolescents could be caused by appropriate preventive measures or interceptive orthodontic treatment performed at an early age.