Possibility, by several drugs, to produce, as collateral effect, gingival overgrowth, is largely described in literature 1,2) since 1939, when Kimball, reported for the first time the case of a hyperplasic modification in the gum of an epileptic patient treated with Dilantin. Actually, the agents causing gingival hyperplasia belong to three categories: anticonvulsivants (Phenytoin), immunosuppressant (Cyclosporine A) and calcium channel blockers for cardiovascular disease. 3) The last belongs to the so called “calcium channel blockers” and its main action is to stop the passage of Ca++ ions through the membranes of the muscular cells of vessels and heart without modifying the haematic level of the calcium; in this way the contractile processes of the main arteries and coro-naries are inhibited. 4–6) Gingival overgrowth normally appears within 13 months after the start of therapy, beginning from the interdental papilla; 7) clinical manifestation usually is similar with different type of drugs, even if some authors reported a more lobulated and hyperaemic gingival for patients treated with Cyclosporin A. 8) Histopathologic characteristics of gingival lesions are very similar independently from the drug assumed, and they consist in an excessive accumulation of extracellular matrix proteins (e.g. collagen) or amorphous ground substance, with a connective tissue response more implicated than epithelial cell layer involvement; 9) it is also always present a lym-pho-plasmocitary infiltrate, typical of chronic inflammation even when an acute flogosis, due to the bacterial plaque in the sulcular areas, is associated. 10,11) In these conditions, when the anamnestic investigation leads to the hypothesis of a relation between the agent assumed and the conditions of gums, it is mandatory to contact the specialist who prescribed the agent in order to substitute this drug with another, if possible. The surgical therapy is not easy, due to the particular general clinical situation of these patients: 12) even if, in most important cases conventional intervention by scalpel must be done during hospitaliza-tion in order to have a control of bleeding because, in this kind of patient, risk is very high, 13,14) several authors proposed also the use of laser surgery in alternative to conventional intervention: less bleeding and pain, easier post-operative period, much less wound contraction and scarring are the advantages of this technique vs. scalpel. 15) Use of several different wavelengths to treat gingival overgrowth, such Argon, Nd:YAG, Diode, Er,Cr:YSGG, Er:YAG and CO2 has been reported in several works, 16–18) but in the case below described we decided to use Carbon Dioxide Laser, considering the importance of the lesion, the age of the patient and his general health conditions. 19) CO2 is a gas active medium laser which emits a beam of 10600 nm, in region of far infrared spectrum, with a great affinity for water and, even if it generally has a delivery system by articulated arm, it can also be distributed by hollow fibbers; the great advantage of this laser is that it can emit in C^W (Continuous Wave), in Pulsed Mode and also in Superpulsed Mode and this last way allows to control thermal elevation in target tissue. In this case we decided to utilise it in two modalities, superpulsed to make ablation and CW to produce coagulation in the tissue.