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Background: Early Childhood Caries (ECC) is a significant health concern, predominantly affecting young children worldwide, especially in socio-economically disadvantaged communities. ECC is a multifactorial disease, influenced by dietary habits, oral hygiene practices, and socio-economic factors. Aim: This article aims to summarize the etiology, risk factors, prevention strategies, and clinical management of Early Childhood Caries based on a comprehensive review of current literature and studies. Methods: The review includes analysis of multiple studies, surveys, and articles related to ECC, focusing on prevalence, risk factors, and prevention strategies. Data were collected from sources such as PubMed, NCBI Bookshelf, and various pediatric dentistry journals. Results: ECC prevalence varies widely across different regions, with rates as high as 90% in certain indigenous communities. Key risk factors include early oral colonization by cariogenic bacteria, frequent sugar consumption, inadequate oral hygiene, and enamel hypoplasia. Prevention strategies emphasize reducing bacterial transmission, limiting dietary sugars, promoting regular tooth brushing, and using fluoride treatments. Conclusion: Effective management of ECC requires a multi-faceted approach involving public health policies, caregiver education, and early intervention strategies. Understanding the complex interplay of risk factors can aid in developing targeted preventive measures.