Background: Molar Incisor Hypominersalisation (MIH) presents a significant challenge in pediatric dentistry due to developmental enamel defects affecting the first permanent molars and incisors. These defects result in color changes, structural deficiencies, and increased susceptibility to caries and sensitivity. Despite its clinical importance and growing prevalence, there is a noticeable knowledge gap among dental students. Objective: This study aims to evaluate the knowledge, attitudes, and practices regarding MIH among dental students in Tamil Nadu, providing insights into their understanding of MIH, including its etiology, clinical presentation, diagnostic criteria, and management strategies. Methods: A cross-sectional survey was conducted with 324 dental students from various colleges in Tamil Nadu. Participants included third and fourth-year students and interns. The survey assessed students' familiarity with MIH, their ability to diagnose and manage the condition, and their perceptions of its prevalence and etiology. Data were analyzed using descriptive statistics and chi-square tests, with significance set at p < 0.05. Results: The response rate was 94%. Most students (76.3%) were familiar with MIH, with 56% learning through books and 37.8% through lectures. While 79% were aware of the clinical features of MIH, 70% knew how to apply this knowledge, and 40% had the clinical ability to identify MIH. However, 59% found it challenging to differentiate MIH from other defects. Genetic and environmental factors were identified as significant etiological factors by 45.4% and 41.2% of students, respectively. Preformed crowns and composite restoration were the preferred treatment options among the students. The findings highlighted the need for enhanced training on MIH management. Conclusion: The study underscores the importance of integrating comprehensive MIH education into the dental curriculum to equip future dental professionals with the necessary skills and competencies. Addressing the gaps in knowledge and practice will improve MIH management and patient outcomes in pediatric dentistry.