To describe the incidence, demographic and clinical features of 1187 localized gingival enlargements. 1187 cases of localized gingival enlargements diagnosed during a 20-year period were retrospectively collected. The patients? gender and age, as well as the main clinical features of the tumors were retrieved from the biopsy report forms. The 1187 localized gingival enlargements represented 6.23% of 19.044 biopsies performed during the study period. 756 females and 427 males were affected with a mean age of 41.92±19.68 years. The lesions appeared as smooth (52.4%), granular (17.9%) or rough (13.16%) tumors, elastic (50.73%) or soft (29.56%) in consistency and red (60.8%), normal (28.58%) or white (8.17%) in color. The majority of the lesions (85.17%) were reactive in origin with pyogenic granuloma being the most common. In 1.1% of the cases a diagnosis of malignant lesion was rendered. All localized gingival enlargements should be submitted for microscopic examination because in approximately 1% of cases they are malignant.