We report 52 cases of a unique and pathologically distinctive form of inflammatory gingival hyperplasia in young patients. Clinically, the average age of patients in this study was 11.8 years, with a 2.3:1 female predominance. Caucasians comprised 77% of the cases, and nearly all of the lesions were located on the anterior gingiva, with 81% affecting maxillary gingiva. The most classic clinical presentation was a papillary, often pedunculated, red and easily bleeding gingival overgrowth in young patients. Histopathologically, the lesions exhibited a subtle papillary epithelial hyperplasia with prominent intercellular edema and neutrophilic exocytosis of the hyperplastic surface squamous epithelium. Based on the characteristic clinical and histologic features, we conclude that this lesion is a distinct subtype of gingival hyperplasia. Although previously described as juvenile spongiotic gingivitis, we propose the term localized juvenile spongiotic gingival hyperplasia as a more accurate designation.