Purpose <p>The aim of this retrospective study was to analyse the dental and medical parameters, including peri- and postoperative management and complications, of patients with special healthcare needs receiving dental treatment in a tertiary care hospital setting.</p> Methods <p>A total of 154 patients (mean age 7.8 ± 4.1&#xa0;years) who received dental treatment under general anaesthesia or analgosedation at the Department of Paediatric Dentistry of the XXX University in XXXXXXX between 2021 and 2023 were divided into the following diseases: metabolic disease, nervous system disorder, congenital heart disease, tumour disease, gastroenterological disease, genetic syndrome, pulmonology disease and coagulopathy. Caries experience (dmf-t/DMF-T), type of anaesthesia and pre- and perioperative parameters were recorded.</p> Results <p>Regardless of disease, all children showed higher caries experience in the primary dentition compared to permanent dentition (mean ± standard deviation; 6.44 ± 4.85/2.01 ± 3.87). Most of the children suffered from genetic syndrome, followed by congenital heart and metabolic disease. Dental treatment was mostly performed under general anaesthesia. 92.2% of those patients were intubated orotracheally and 66.9% received antiemetics. The complication rate was lower than 3%.</p> Conclusions <p>Data show that special healthcare needs patients regardless of kind of disease are highly affected by caries and require dental treatment. Most dental restorations were performed under general anaesthesia. Regardless of disease and type of anaesthesia, the complication rate was low, which underlines the high clinical relevance of adequate dental care under general anaesthesia for this vulnerable patient group.</p>