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Introduction: Dental caries is the most prevalent oral disease among childhood. Dental caries in primary dentition is often neglected since they exfoliate, and its treatment is considered as economic burden among lower socioeconomic families. Aim: To assess the prevalence of dental caries in the primary teeth of 3–6–year-old preschool Anganwadi children in Mudhol town of Karnataka. Materials and Methods: A cross-sectional study was conducted over 758 children, aged 3–6 years studying in 15 Anganwadis of Mudhol. Type III WHO method of examination was followed, and decayed, missing, filled teeth (dmft) index was recorded according to the WHO criteria. The data were analyzed by Z-test and Chi-square test using SPSS version 17 software. Results: Among the study population, 62.14% were found to be affected by dental caries. The prevalence of dental caries increased with increase in age. No significant difference was found with respect to gender. The mean dmft was 2.34. The filled component was nonexistent among these children. Second primary molars were the teeth most affected by caries followed by first molars and central incisors. Conclusion: Dental caries prevalence of 62.14% and mean dmft of 2.34 among Anganwadi children of Mudhol town is a cause for concern. The nonexisting filled component among these children indicates high unmet restorative treatment needs. Dental health services should be made available in the peripheral areas to meet the needs of young children.