From December 2005 to June 2007, a total screening of all 1418 government primary schools in Khartoum State, Sudan, was performed to estimate ocular problems among children aged 6-15 years. We screened 671,119 children (56.7% males) for significant refractive error and other eye ailments. Ocular problems were found in 20,321 (3.03%) children. The 3 localities with highest ocular pathology were Karary (26.2%), Ummbada (21.0%) and Jabal Awlia (15.7%). The overall prevalence of refractive error was 2.19%. Myopia was found in 10,064 (1.50%) children while 4661 (0.70%) were hyperopic. Other ocular problems included vernal keratoconjunctivitis, vitamin A deficiency, microbial conjunctivitis, strabismus and corneal opacity. Only 288 (0.04%) children were diagnosed with active trachoma: 86.5% of these were from Ummbada locality, on the periphery ofthe State, where transportation facilities are poor and poverty is widespread. Overall, 99% of the eye ailments identified are either treatable or preventable. To reduce these and to achieve the goals of Vision 2020, an effective and efficient school health programme is needed.