Oral health–related quality of life (OHRQoL) is the most important patient–reported outcome measure in oral health research. Early childhood caries can produce an impact on the quality of life of preschool children and their parents, affects oral health and well–being. Objectives: To assess the impact of Sever Early Childhood Caries (S–ECC) on the Oral Health Related Quality Of Life (OHRQoL) of children between 2–5 years of age. Methods: A cross sectional study consisted of 300 children of 2–5 years, of private and government preschools in Visnagar, Gujarat. Data was collected. Oral examination using dmft/dmfs index was performed. A previously validated questionnaire (OH–ECQOL tool) was applied. Results: Statistically significant (P<0.001) Pearson co–relation test between the dmft/dmfs index scores and child’s general health and oral health and family impact was observed. Conclusions: Severity of ECC had a negative impact on the OHRQoL of preschool children and their parents.