Background: Early childhood caries (ECC) is one of the most common dental diseases among the preschoolers, leading to suboptimal health. A study was planned to evaluate the prevalence of ECC in preschool children in the age group between 18 and 72 months and its relationship with parents education and socioeconomic status of the family. Materials and Methods: This cross-sectional study was conducted among 2771 children selected randomly, in the age group 18-72 months and attending playschools and primary schools in urban, semi-urban, and rural areas of Salem, Tamil Nadu. A modified Winter et al. questionnaire and a proforma were used for collecting information on each child. The completed questionnaire and proformas were statistically analyzed and evaluated. The statistical analysis was done using Students t-test and analysis of variance (ANOVA) to obtain mean values. Results: The prevalence of ECC in Salem was 16% with a mean dfs of 5.23 +/- 1. Prevalence was high among the children of low socioeconomic status group and the children of working mothers, with a mean dfs of 10.47. Conclusion: The prevalence of ECC was 16% in Salem, Tamil Nadu. ECC was seen more in children of working mothers, lower parental education, and lower socioeconomic groups.