Background: Idiopathic gingival fibromatosis is known to be a benign slow growing proliferation of the gingival tissue. It is genetically heterogeneous, associated with syndromes and rarely presents as an isolated disorder. Aggressive periodontitis (AP) is a disorder that results in severe rapid destruction of the tooth-supporting apparatus and is also a genetically transmitted disorder of the periodontium. In the case of gingival enlargement there will be an excessive display of gingiva affecting the esthetic and functional problems. Gingival enlargement in association with generalized AP is very rare. Case description: A 23-year-old female was reported with a recurrence of gingival enlargement along with generalized tooth mobility. On detailed history, clinical and laboratory findings, it was diagnosed as recurrent idiopathic gingival enlargement with generalized aggressive periodontitis. This patient has been followed up for nearly 9 years ever since she first reported to us in the year 2004 with a similar finding. Treatment included extraction of teeth with a hopeless prognosis, through phase I therapy, local drug delivery of gengigel^® 0.2% hyaluronic acid, gingivectomy using electrocautery, follow up visits and prosthetic rehabilitation using a treatment partial denture. Conclusion: In generalized AP, rapid destruction of periodontal tissues can be prevented by early diagnosis. Also, diagnosis of GAP can be complicated by associated conditions like gingival enlargement. Therefore the diagnosis should be based on complete history radiographical microbiological and clinical findings. The use of local application of agents such as Gengigel^® is recommended to improve the periodontal condition.