Early childhood caries (ECC) is a disease characterized by the presence of one or more cavitated or non- cavitated carious lesions, or missing or filled tooth surfaces, in children 71 months old or younger. ECC is a chronic condition that requires appropriate management. Management should be guided by the principles of minimum intervention dentistry (MID), which aims to restore function, form, and aesthetics with minimal loss of tooth structure. Based on the extent of lesion removal, MID strategies for the treatment of ECC can be classified as non-invasive, micro-invasive, minimally invasive, and mixed approaches. Non-invasive strategies, defined by the absence of tooth hard tissue loss, include diet control, biofilm control, and remineralization techniques. Micro-invasive strategies involve altering the tooth's surface characteristics during acidification, resulting in the loss of only a few micrometers of hard tissue. These strategies also include the application of sealants and resin infiltration. Minimally invasive strategies, used for cavitated deciduous teeth requiring removal of dental hard tissue, focus on selective caries removal followed by long-lasting restorative techniques. Mixed strategies incorporate elements from the aforementioned approaches, such as the Hall technique and non-restorative cavity control. When selecting an MID strategy for ECC lesions, factors such as lesion activity, cavitation, and cleanability should be prioritized, along with considerations of caries risk, age, and dentition. A rational selection of an MID strategy should be based on up-to-date expert consensus guidelines. The primary goal of ECC management is to preserve the teeth in the oral cavity until natural exfoliation, ensuring they remain symptom-free while maintaining optimal form, function, and aesthetics.