Early childhood caries (ECC) is defined as the presence of one or more cavitated or noncavitated lesions, missing (due to caries), or filled surfaces in any primary tooth in a child under six years of age. ECC is a prevalent and chronic condition that requires effective, evidence-based management. This narrative review aimed to present an evidence-based overview of minimally invasive dentistry (MID) strategies for the management of ECC, focusing on their clinical rationale, classification, and application based on lesion characteristics. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science to identify recent studies, systematic reviews, and clinical guidelines published between 2019 and 2025. MID strategies were categorized as non-invasive, micro-invasive, minimally invasive, and mixed, based on lesion activity, cavitation, and cleanability. Evidence from randomized controlled trials and meta-analyses supports the use of micro-invasive methods like sealants and resin infiltration for non-cavitated lesions, while minimally invasive and mixed strategies, including the Hall technique and selective caries removal, are more appropriate for cavitated l
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