Introduction: The National Children's Oral Health Survey reported a high prevalence of untreated dental caries (42%) and periodontal problems (85%) amongst 15-year-olds in South Africa (NCOHS, 2002). Objectives: To determine the oral health related knowledge, attitudes and practices of adolescents, to inform oral health promotion strategies. Method: This was a descriptive study of grade eight learners in a metropolitan area in the Western Cape Province. Demographic data, oral health related knowledge, attitudes and practices were measured by means of a self administered questionnaire. Knowledge questions included the extent of their knowledge of oral diseases, the prevention and treatment thereof and the sources of their information. Practices included the frequency of tooth-brushing and dental attendance, dietary habits and smoking prevalence. Attitudes were measured by their self perceived need for treatment and their preferred dental treatment. Questions about knowledge, diet and their perception of good oral health were open ended and coded by the researcher. Results: The response rate was 90% (n=249). Learners' age ranged from 12-16years (mean age= 13.7 years); 52% were males. Their reported oral health problems were gingivitis (55%) and dental caries (31%). A small percentage had adequate knowledge of dental caries and gingivitis (17% and 9% respectively). Their preferred treatment for caries was extractions (76%). Most (85%) report to brush their teeth twice daily, all consume sugar containing beverages daily, 54% visit a dentist only when symptomatic, 45% have been exposed to preventive treatment, 24% smoke. Conclusions: Learners have inadequate knowledge to make informed decisions about their oral health. They have a negative attitude to maintaining their natural teeth in spite of having access to resources that could improve their health. A comprehensive school based programme including educators, learners, their parents and dental service providers is required to improve the oral health of this group.