INTRODUCTION: Early Childhood Caries (ECC) remains an important childhood disease affecting a considerable portion of young children. ECC has been associated with inappropriate feeding patterns and excess consumption of fermentable carbohydrates. OBJECTIVES: The purpose of this study was to compare children affected by ECC and S-ECC and those who are caries free regarding their dietary habits. MATERIALS AND METHODS: Thirty children aged 2-6 years free from any systemic disease were selected for this study. Children were recruited from those attending the outpatient clinic at the Faculty of Dentistry, Alexandria University. The children were divided into three groups. Group 1 consisted of 10 children who had ECC. Group 2 consisted of 10 children presenting with S-ECC, while Group 3 included 10 children who were caries free serving as the control group. After clinical examination, the children's parents were asked to complete a standardized 3-day food diary form where they reported all the foods, beverages and snacks the child consumed over a 3-day period. Finally, a fermentable carbohydrate analysis was performed to determine the average number of exposures per day. RESULTS: Significant associations were found between the increasing severity of caries and the feeding habits of the children. The total carbohydrate scores for the caries free, ECC, and S-ECC groups were 90.00 ± 17.71, 104.56 ± 38.33, and 161.33 ± 24.12 respectively. There was a statistically significant difference among the three groups (P<0.0001). CONCLUSIONS: The increase in fermentable carbohydrate intake is associated with Early Childhood Caries.