This study described the pattern of trichiasis, active trachoma and trachoma risk factors in 9 governorates of Yemen plus Socotra Island, using a rapid assessment during October and February 2004. A total of 3169 children aged 1–9 years were examined in a central meeting point or at home. Active trachoma was found in a high percentage of children in Al-Jawf, Mareb and Shabwah governorates and the SAFE strategy (Surgery, Antibiotic treatment, Facial cleanliness, Environmental improvement) should be directed toward these governorates. Trichiasis cases were also found in Hadramout and Taiz, suggesting that eyelid surgery should be provided in these governorates.