Background: There has been no study in Kabul on reasons for permanent tooth extraction. This study aimed to determine the prevalence and reasons for tooth loss in a sample from two dental clinics in the west of Kabul. Methods: During a 6-month period (April-September 2019), the reasons for every extraction of a permanent tooth were recorded. Different reasons for tooth extraction were assigned, such as, dental caries, periodontal disease, eruption problems, trauma, orthodontics and others. The data requested for each extraction were: patient age, gender, previous treatment, educational level, type of tooth removed and the reason for its extraction. Results: young people aged between 20 - 29 years old had the highest percentage of extraction. Periodontal disease (39%) followed by caries (20%) was the most common reason for tooth extraction. Maxillary and mandibular first molars were removed most frequently (31%). 29% of patients have treated their teeth before extraction and RCT (Root Canal Treatment) (19%) is the most common previous treatment. Tooth loss has an opposite relationship with education level. People with high education level, loose their tooth less (14%). Conclusion: periodontal disease was the most common reason for tooth loss in Kabul, Afghanistan and a high percentage of tooth loss is seen among young people. Educating and preventive programs need to be implemented in order to reduce tooth loss.