This study examined the maxillary labial frenum (MLF) and its clinical implications, focusing on its anatomy, developmental changes, and management strategies. The MLF functions as a connective tissue linking the upper lip to the alveolar ridge, facilitating essential processes such as speech production, food consumption, and the maintenance of proper dental alignment. Abnormal development or attachment can result in midline diastema, speech difficulties, and breastfeeding challenges. During growth, the MLF typically migrates from the alveolar crest in infancy to the mucogingival junction by adulthood; however, in some cases, this migration fails, leading to persistent diastema or other oral health concerns. The timing of frenectomy remains unclear. Certain experts advocate for early intervention to facilitate orthodontic treatment, while others recommend postponing surgical procedures until orthodontic efforts are completed, as the majority of diastemas close naturally with the eruption of permanent canines. In instances where diastema persists, frenectomy may be necessary to prevent relapse. Restrictive frenum attachments have been linked to breastfeeding difficulties; however, feeding outcomes can also be influenced by factors such as maternal technique and infant feeding patterns. This review highlights the need for individualized assessment and treatment planning, balancing surgical intervention with natural development, to ensure the best outcomes for each patient.