Background - Early childhood caries (ECC) is a public health problem among preschool children. One of the most common condition seen in children with ECC is malnutrition. Objectives - This study investigated the prevalence of ECC and its association with body weight and anemia among preschool children in rural area of central India. Materials and methods - 1332 children of age 2 - 5 years from the rural area of central India were evaluated. Anthropometric measurements and clinical tests were used to assess the nutritional status of the children. Results - It was found that 45.1 % children were diagnosed with SECC and 9.15% and 46.08 % amongst them were anemic and iron deficient, respectively this was done based on the criteria established by the World Health Organization. 44.93% of children with SECC were classified as underweight, based on national standards for the body mass index. Multivariable logistic regression analysis was used to determine the relationship between the caries status of the children and anemia (p < 0.05). Conclusion - Clinicians and dentists should provide treatment to improve both the oral hygiene and the nutritional status of children with SECC, as SECC is strongly associated with anemia (5.75-fold)