The region continues to be the worst in Britain for the amount of litter found on its streets, parks and public spaces, according to the latest figures from Keep Britain Tidy.
Keep Britain Tidy is an environmental charity and the anti-litter campaign for England that produces the Local Environmental Quality Survey England, which is funded by the Government's Department for Environment, Food and Rural Affairs.
Keep Britain Tidy carries out surveys to assess the cleanliness of local places from litter and dog mess to graffiti and fly-posting. The information is used by local councils to see how they are performing against the national average and said it is useful for Government and residents to see how clean or dirty our country is.
The survey shows that the cleanliness of areas overall is getting worse with the national benchmark slipping 2% with a 'national cleansing index' score falling from 69% in 2007/08 to 67% in 2008/2009.
Keep Britain Tidy said the higher the national cleansing index score the cleaner the area is considered to be.
Within the North West, the 'national cleansing index' score has fallen from 64% in 2007/08 to 60% in 2008/2009 and maintains its position at the foot of the regional table for a third consecutive year.
Although values declined for litter, leaf fall, staining and graffiti and staining at bus stops and litter on landscaping also deteriorated, Keep Britain Tidy said overall standards for litter remain unsatisfactory in the North West.
Surveyors visited 12,540 sites in 54 local council areas across the nine regions of England between April 2008 and March 2009.
Keep Britain Tidy said the South West continues to be the cleanest region.