Gingival enlargements (GEs) are a commonly observed clinical entity in dentistry. The etiology maybe local, systemic, or a combination. Having a good diagnostic certainty of the type of GE helps the clinician to not only manage the entity locally but facilitates a thorough workup of the systemic factors. This article offers an in-depth look at the diagnosis and subsequent clinical management strategies for various forms of GE. It emphasizes the importance of accurately recognizing the diverse clinical presentations of GE, guided by its etiopathogenesis, clinical features, and other investigations. Achieving an accurate diagnosis is crucial for effective management.