Background. Children with Down syndrome (DS) frequently experience nutritional issues. Some of them are attributed to gastrointestinal tract abnormalities, while others are due to feeding behaviors. Previous studies have reported inconclusive results regarding the prevalence of dental caries among individuals with DS. Objectives. The study aimed to assess the nutritional status, prevalence of dental caries and oral hygiene level among children and adolescents with DS aged 8-15 years in comparison to healthy peers. Material and methods. A case-control observational study was carried out in Damascus, Syria, and its surrounding countryside. The study included 135 participants between the ages of 8 and 15 years who were divided into 2 groups based on the presence of DS. The data was processed using the IBM SPSS Statistics for Windows software, v. 26. The Kruskal-Wallis H test, Mann-Whitney U test and chi 2 test, as well as Spearman's correlation were implemented. Results. Almost half of the participants in the DS group were classified as overweight or obese (33.9% and 19.1%, respectively), while the percentages of overweight and obese children in the control group were 14.9% and 10.4%, respectively. No statistically significant results were noted between oral hygiene levels and the prevalence of dental caries among the study groups (p > 0.05). Only 50% of parents thought that their children needed help during daily oral hygiene practices; however, only 39.4% of parents actually provided such assistance. Conclusions. Children and adolescents with DS exhibited a tendency toward shorter stature in comparison to their peers. In the DS group, the economic status and paternal education level exhibited an inverse correlation with body mass index (BMI)-for-age. Oral hygiene practices and dietary habits are the most influential factors in the development of dental caries. The DS group followed an unhealthy dietary pattern, characterized by elevated levels of sugar consumption.There is an urgent need for effective promotion programs within the educational plans of schools and centers of special needs. These programs must educate parents and caregivers about effective oral hygiene practices and make them aware of their children's need for help during the oral hygiene process.