Objective Provide an overview of how care needs in permanent residential aged care differ by dementia status. Methods On entry into permanent residential aged care, people's care needs are assessed on the Aged Care Funding Instrument (ACFI). ACFI also captures health conditions that are considered to affect the cost of people's care, such as dementia. Data were compared between 2009 and 2015. Results Assessed care needs have increased regardless of dementia status. However, compared with people without dementia, people with dementia were more likely to be rated ‘high’ in each of the three care need domains. In addition, people with dementia were more likely to require some assistance in specific areas that underlie these broad domains, such as nutrition, continence and cognition. Conclusion Dementia is associated with increased complexity in assessed care needs in permanent residential aged care.