Objective: To assess and compare the knowledge, attitude, and practice of mothers of pre-school children in urban and rural areas toward maintaining child oral health.Materials and Methods: A cross-sectional comparative study was conducted in a convenient sample of 400 mothers of pre-school children (aged 9 months to 3 years) visiting the outpatient department of the Department of Dentistry, Shyam Shah Medical College, Rewa (M.P), India between February 1 and April 21, 2022. The study sample was divided into two groups based on whether they belonged to a rural area (Group A) or urban area (Group B). Group A included 236 participants, and Group B 186 participants. They were served a 24-item questionnaire to assess and compare their knowledge, attitude, and practice toward child oral health. The data were represented as mean and proportions, and a student t test and analysis of variance were performed.Results: In Group A and Group B, 93.64% and 98.17% mothers respectively had the knowledge of cariogenic food. While 66.10% of mothers in Group A and 73.78% in Group B were aware that regular cleaning of teeth protects against tooth decay, only 5.49% of mothers in Group B and none in Group A reported taking their children to routine dental visits; the majority (94.07% in Group A and 78.05% in Group B) had never taken their children to the dentist. Urban background was significantly associated with better knowledge, attitude, and practice scores. Mother’s’ age and education level were significantly associated with better Knowledge, Attitude, and Practice scores in both groups.Conclusion: Mothers can play an important role in promoting positive attitudes and healthy practices toward oral health care in children. Knowledge, attitude, and practice score were found to be significantly low in mothers who belonged to the rural subgroup.