Background: Gingival enlargement is a clinical condition that has been widely studied and is directly associated with specific local or systemic conditions. It is very rare that gingival enlargement presents without a clear underlying etiology.Methods: A 24‐year‐old African American female presented with gingival enlargement that manifested postpartum and was most likely related to changes in estrogen/progesterone. The gingival enlargement was treated with non‐surgical and surgical periodontal therapies.Results: There was no evidence of recurrence of the gingival enlargement at 9 years post‐treatment.Conclusions: The etiology in this case remains unclear and could not be strongly supported by any reports in the literature. Future studies on gingival enlargement may explain such an unusual clinical occurrence.