The demand for root coverage in multiple gingival recession defects has increased in recent years. Compared to isolated recession, multiple gingival recession defects are much more challenging due to various limiting factors and require more sophisticated surgical techniques. This review aims to address recent progress in the management of multiple recession defects. The subepithelial connective tissue graft (SCTG) procedure, while effective, is limited due to tissue availability and patient preference to avoid a donor harvest site. Different surgical techniques and biological materials have been studied in an attempt to find ideal alternatives. Based on the studies reviewed, the SCTG procedure still remains the gold standard in terms of percent root coverage. Acellular dermal matrix allograft in conjunction with different flap designs has shown comparable, satisfactory results up to 1 year postoperatively. Other materials such as porcine collagen matrix and enamel matrix derivative also show some promise. Well-designed studies with long-term outcomes are still needed.