Background: Early childhood caries (ECC) is a public health problem. Studies have reported propinquity between ECC and maternal knowledge, attitudes, practices, age, education, and smoking habits. Objective: To assess the evidences of association between maternal factors and early childhood caries. Method: This comprehensive literature search was conducted for the period 2006 to 2016. Databases included Pubmed, Google Scholar, and cross references. Two authors independently selected the studies and extracted the data. Mesh terms "caregivers", "mother", "caries", and "knowledge" were used. 506 articles were selected after removing the duplicates and those that did not match the search criteria. Methodological quality assessment was done using a tool based on Strobe and NIH checklists for observational studies. Results: 10 papers were finally included. The mothers' caries status, knowledge, socioeconomic status and smoking habits significantly affect the caries status of children, whereas the effects of education status and breast feeding were inconclusive. The studies were heterogenous. There was a lack of studies on children aged 30 months. Conclusion: This systematic review of observational studies indicates Level IV evidence for an association between maternal factors and early childhood caries. Dental public health significance: Oral health promotion of mothers can significantly reduce ECC. Keywords: caregivers, mother, caries, knowledge