INTRODUCTION: Early Childhood Caries (ECC) is a multifactorial disease and has numerous biological, psychological and behavioral factors. It is a significant public health problem with consequences for the growth and development of affected children OBJECTIVES: The aim of the study was to assess differences between children with early childhood caries and caries free children in socioeconomic background, previous dental visits, oral hygiene practices and dietary habits. MATERIALS AND METHODS: Parents responded to a questionnaire about children's background (age, sex, parental occupation and education and birth rank), in addition to previous dental visits, nursing history, tooth brushing frequency, use of fluoridated toothpaste, parental supervision of brushing and dietary habits (snack type, frequency and daily quantity). Clinical examination assessed caries using World Health Organization criteria and plaque using Loe and Silness Plaque index. The sample consisted of 84, 4-5-year-old children who visited the pediatric dentistry clinic of the Faculty of Dentistry, Alexandria University in 2016. Equal number of cases (children with ECC) and controls (caries free children) were included. RESULTS: Children with ECC were significantly more likely to be first borne compared to caries free children (71.4% and 52.4%, P= 0.006). Previous dental visits were reported in 38.1% of children with ECC compared to 4.8% of caries free children (p < 0.0001). Exclusive breast feeding was reported in 83.3% of children with ECC compared to 59.5% of caries free children (p=0.02). Plaque index in children with ECC was significantly higher (0.70±0.53) than that of caries free children (0.39±0.50, p=0.001). CONCLUSIONS: Being first borne, history of previous dental visits, exclusive breast feeding and high plaque index were factors that differed significantly between children with ECC and caries free children