In Mali one of the options of the fight against blindness is to implement the "CHANCE" strategy. The antibiotherapy is one of the strategy which has always a question who should be treated by which process (mass treatment focused treatment) and when we should treat for both mass treatment or targeted treatment, that is why this study has been initiated to evaluate the level of active trachoma (TI/TI) and the trichiasis in the district of Douentza and undertake the appropriate actions to fight for its reduction. It was a cross sectional survey done in may 2005 following a methodology based on the random size described by WHO (world health Organization) in the evaluation of the health coverage. The study targets 1450 ten years old children, less than 1564 of fifteen years old children and respectively for the estimation of the trachoma prevalence and trichiasis. The families chiefs have been asked or interviewed for the risk factor and the happening of trachoma, mothers were interviewed about their attitude and practices in hygiene. The active trachoma prevalence rate among children is estimated at 13.2 ± 2.7% in the district. Kids from 0 to 4 are more affected than those from 5 to 10 years old with p < 0.001. The trichiasis rate is 0.6% The pumps (30.3%), the communicative wells (23.8%) the traditional wells not maintained (19.4%), and the maintained wells (15.7%), faucets (9.7%) are the essential sources of water which is not sufficient. The presence of animals in 40.40 to 76.1% families, the low percentage of families with latrines (toilets) 41.40%, the presence of waste water and garbage in 25.3% families, 42.9% outside the families or 31.8% anywhere were observed during the study. Based on all these results, the antibiotic mass treatment to reduce the active trachoma is a necessity; this mass treatment combined with an efficient IEC to improve body and environmental hygiene will have an impact on the trachoma in the district of Douentza.