Excessive screen exposure is a growing concern in early childhood, affecting parent-child relationships and children’s behavior. This study examines how parent-child interactions and parental screen use affect preschoolers’ screen time, and compares screen time between urban and rural children in Central Province, Sri Lanka. A cross sectional survey was conducted among 423 parents from 15 randomly selected preschools in Central province. Data were collected using a parent reported questionnaire on parental screen use, parent-child interactions and children’s screen time. Using census data related to preschools, urban and rural classification was done. Data were analyzed using SPSS version.26 with Mann–Whitney U test tests, Spearman’s rank correlations analysis. The mean daily screen time among children was 1.89 ± 1.35 hours. Urban children (n = 228) had significantly higher screen time (2.28 h) than rural children (n=195,1.38 h) (p < 0.05). Children’s screen time showed significant positive correlations with parental device use during meals (? = 0.112, p = 0.022), interactive play (? = 0.172, p < 0.001), educational use (? = 0.189, p < 0.001), travelling (? = 0.182,p < 0.001), and bedtime routines (? = 0.126, p = 0.010). Parent child interactions, including teaching/learning (? = -0.119, p=0.014) storytelling (? =−0.99,p=0.042) and outdoor play (? = -0.96, p=0.050), were negatively correlated with children’s screen time. Parental screen use and interaction activities influence preschoolers’ screen exposure. Urban children showing higher screen time than rural children. Improving parent–child interactions and parental awareness can help to reduce excessive screen time.