Abstract: Background: Dental caries remains a major public health concern among children globally, with prevalence rates differing between urban and rural regions. This study aims to assess the prevalence of dental caries among school-going children in Jamalpur, Bangladesh, and identify associated risk factors. Methods: A cross-sectional study was conducted from January 2023 to December 2023 at the 250-bed General Hospital in Jamalpur. A total of 200 school-going children aged 6 to 12 years were recruited, with an equal distribution of 100 children from urban and 100 from rural areas. Data were collected through a structured questionnaire and clinical examinations to assess dental caries prevalence. Results: The overall prevalence of dental caries among participants was 68%. A significant difference was observed between urban (60%) and rural (76%) children (χ² = 6.25, p = 0.012). Multivariate logistic regression analysis revealed that children whose parents had primary education or less (OR = 2.1, 95% CI: 1.3–3.4, p = 0.002), those from low socio-economic backgrounds (OR = 1.8, 95% CI: 1.1–3.0, p = 0.015), and those consuming sugary snacks more than three times a week (OR = 2.5, 95% CI: 1.5–4.2, p < 0.001) were at a higher risk of dental caries. Additionally, infrequent tooth brushing (less than twice daily) was significantly associated with dental caries (OR = 2.8, 95% CI: 1.6–4.8, p < 0.001). Conclusion: This study emphasizes the significant occurrence of dental caries among school-aged children in Jamalpur, with a higher prevalence in rural areas. Factors such as socio-economic status, dietary patterns, and oral hygiene habits play a crucial role in increasing the risk of dental caries. The results highlight the necessity for focused public health initiatives to enhance children's oral health in Bangladesh.