Purpose: To measure the prevalence and trends in childhood trachoma within remote, largely Aboriginal communities.Methods: Children from eight remote communities of the Goldfields region of Western Australia were examined annually over 12 years from 1992 to 2003. World Health Organization trachoma grading system was used, with the data collected prospectively.Results: In this study 2975 of 3483 child ocular examinations were analysed, 72% of whom were Aboriginal. The mean age was 8 years 9 months with a range from 1 month to 17 years 11 months. The overall prevalence of active trachoma was volatile ranging from 44% in 1993 to 5% in 1997 and 2001. The prevalence of World Health Organization grade TI disease showed a significant decline from 5% to less than 1% (P = 0.001).Conclusion: The prevalence of active trachoma in children of these eight remote communities of the Goldfields region of Western Australia was volatile. The prevalence of intense inflammation has dropped to very low levels. A significant reservoir of less severe inflammation remains.