Aim: The aim of this study is to assess the maternal risk factors and its relationship with early childhood caries (ECC) among preschoolchildren in Mangaluru city. Methods: Children aged 3–5 years attending preschool (Anganwadi) and their mothers were included in the study. A total of 120 child–mother pairs participated in the study. The maternal risk factors were assessed by a pretested questionnaire. After obtaining the consent, the mother and their children were clinically examined for dental caries using the WHO criteria (1997). Results were analyzed using SPSS 18.0. Results: Significant difference was found in mother's caries activity, high level of Streptococcus mutans, brushing frequency, diet of the mother, and their child's caries experience. Conclusion: A relationship between maternal risk factors and ECC is a result of a multifactorial and a comprehensive model that includes psychological and behavioral aspects. Caries prevention strategy should be that every child should receive oral care before age of one so that needful children can be instituted with preventive measures and their parents can be targeted for educational programs.