Early Childhood Caries (ECC) remains one of the most prevalent chronic diseases affecting children worldwide. ECC is a multifactorial disease characterized by the presence of one or more decayed, missing, or filled tooth surfaces in primary teeth of children younger than six years. The condition negatively impacts oral health, nutrition, growth, speech development, quality of life, and overall well-being. Effective prevention strategies involve a combination of parental education, dietary counseling, fluoride use, oral hygiene promotion, regular dental visits, community-based interventions, and emerging digital technologies. This review examines the epidemiology, risk factors, pathogenesis, evidence-based prevention strategies, public health approaches, and future innovations in ECC prevention. Current evidence indicates that early intervention and multidisciplinary preventive programs significantly reduce ECC incidence and improve long-term oral health outcomes.