Purpose: To investigate whether feeding and oral hygiene practices of preschool children are associated with the risk and prevalence of Early Childhood Caries (ECC). Materials and Methods: A cross-sectional study comprising 1250 children aged 3 to 5 years from Belgaum was designed. On the first day, validated questionnaires along with parental informed consent forms were distributed to the children and were collected after a week. Validated questionnaires consisted of 20 close-ended questions pertaining to feeding and oral hygiene practices. Consent was obtained from parents of the 1116 children who were examined for ECC. Data analysis included correlation coefficients and logistic regressions. Results: Among the children studied, 97.3% were breastfed, of which 41.25% were breastfed until 2 years of age. Seventyfive percent of children who were breastfed beyond 2 years were affected by ECC. Exclusive bottle feeding was practiced in 46.15%; 64.85% of them suffered from ECC. Burping was not practiced in 25.18%, and 68.68% of these were affected by ECC. ECC was more prevalent in 89% of children who were weaned later than 12 months of age. Parental assistance for oral hygiene was not seen in 37.27% and 67.22% of these suffered from ECC. Overall, 63.17% of the children were affected by ECC. Conclusion: Prolonged breastfeeding, absence of burping the child, delay in starting oral hygiene practices and lack of parental assistance with the same were shown to be significant determining factors for ECC. Health education and proper guidelines on feeding and oral hygiene practices can substantially reduce the risk and prevalence of ECC. Keywords: burping, early childhood caries, feeding practices, oral hygiene practices, preschool children