Background: Early childhood caries is highly prevalent in preschool children in many countries. This has been attributed to many factors. The awareness about the disease, dentition, oral health, and preventive measures are generally lacking in communities. Objective: Reviewing the current literature on early childhood dental caries, clinical features, etiological factors, management, and prevention. Methodology: PubMed database was used for articles selection, and the following keys used in the mesh (“Early Childhood Caries” [Mesh] AND “Diagnosis” [Mesh] AND “Management” [Mesh]). Review: In children, there are many risks for teeth decay and most notably of those are infectious causes, poor dietary style and excessive sugar intake. The diagnosis of early childhood caries is a clinical one where the affected teeth are recognized by their dull white enamel. This clinical sign is a manifestation of demineralization after repetitive damage by bacteria, sugar and acidity. Conclusion: Management of dental caries are central to clinical dental practice. It is, therefore, necessary to understand the condition and what could be done to prevent its occurrence or progression.