The aim of the present study was to evaluate the association between clinical parameters and the presence of active caries lesions on the occlusal surface of first permanent molars. Forty eight children (5.8-13.8 years-old) with at least one first permanent molar present were selected. The clinical parameters evaluated were gender, age, DMF-T and dmf-t, presence of active white spots in other teeth, general plaque index, tooth's dental arch (upper or lower), tooth's side (right or left), presence of visible plaque and eruption degree of the first permanent molars. The first permanent molars were evaluated through visual inspection by two examiners in order to assess the presence of active or inactive caries lesions on the occlusal surface. Univariate and multivariate analyses for determination of the association between clinical parameters and the presence of active caries lesions in these teeth were performed. The presence of active white spots in other teeth was associated with the presence of active caries lesions in the first permanent molars, in both univariate and multivariate analyses (Odds ratio = 8.8 and 1.9, respectively). The presence of abundant visible plaque on the occlusal surface of the first permanent molars (Odds ratio = 3.5 in the univariate analysis, and 3.9 in the multivariate one) also presented a significant association. In conclusion, the presence of active white spots in other teeth and the presence of considerable visible plaque were associated with the presence of active caries lesions on the occlusal surfaces of first permanent molars.