Published reports suggest that children with enamel defects, especially where enamel is missing or breaking down, experience considerable discomfort and are generally more fearful of dental treatment. However, children's oral health-related quality of life in relation to enamel defects has not been reported. The aim of this study was to examine the association between oral health-related quality of life among children (COHQoL) with enamel defects of the first permanent molars and deciduous caries experience. Methods: Children attending pre-primary schools in metropolitan Perth, Western Australia, were recruited and classified for enamel defects using the modified Developmental Defects of Enamel index. Caries experience of deciduous molars and canines was also recorded. Parents completed a child oral health-related quality of life questionnaire. Data were analysed using Kruskal-Wallis, Spearman's rank correlation, chi-square, multiple linear regression and ordered logistic regression to test the factors for their influence on the COHQoL. Results: From the 550 children assessed (mean age 7.2 years) 522 COHQoL questionnaires were returned. Mean COHQoL score was 8.9 (sd 8.8). Bivariate tests showed no association of COHQoL with enamel defect status of the first permanent molars. COHQoL was associated with dmft (mean dmft 1.96, sd 2.62). Higher caries experience children had poorer reported oral health-related quality of life. Conclusion: The presence of enamel defects in the first permanent molars did not affect the children's oral health-related quality of life.