The first, initial and inseparable part of the unique educational system is the organized institutional preschool upbringing and education. Early childhood education plays a key role in children's development and has significant positive socio-economic effects on the entire society. Numerous researches in the world and in our country show that the language, cultural level, general living conditions and the specific way of upbringing and education of the child in the preschool period have a great influence on the child's psychological development and the development of the abilities needed to start school. The paper first gives an overview on the importance and significance of the organized institutional upbringing and education of preschool children, and then we focus on some aspects of the organization of preschool upbringing and education in the Republic of North Macedonia. We briefly give an overview of the growth of institutional preschool care in the last ten years, and we refer to the challenges faced by preschool upbringing and education in Macedonia.