Tunneling technique (TUN) has been introduced as a minimally invasive and highly esthetic treatment option for the treatment of gingival recession, one of the most frequent mucogingival deformities and conditions. The purpose of the present article is to review how specific technique modifications, different grafting materials, and different defect characteristics may affect the outcome of TUN for root coverage. TUN has been shown to be an efficacious root coverage technique that, in combination with various grafting materials, can achieve satisfactory root coverage outcomes in Miller class I and II recession defects that are more predictable in the maxilla and when multiple adjacent defects are treated. Recent evidence suggests that specific technique modifications may be promising for the treatment of challenging multiple Miller class III recession defects. In order to achieve successful root coverage outcomes with TUN, the etiology of the defect should be identified and risk factors controlled, case selection is critical, specific technique modifications may be beneficial, and a variety of graft materials may be utilized.