Gingival enlargement (GE) is an excessive growth of the gum, which causes functional and aesthetic disorders in individuals. Its etiology is closely related to the dental biofilm accumulation; however, other local and systemic factors can modify the response to these irritants, worsening the condition. This study objective is to determine the GE prevalence in patients with fixed orthodontic appliances and its distribution. A cross-sectional study was conducted in 105 patients older than 15 years, attended at the Postgraduate Orthodontic Clinic of the University of Cuenca. A questionnaire provided information on: sex, age, use of mouthwash, prior periodontal treatment, and stationary apparatus time use. A clinical examination was carried out to determine the periodontal biotype, cementation additives material excess, and the probing depth was evaluated with a periodontal probe PCP 11.5. Any value equal to or greater than 3.5mm was considered as GE and classified according to grade and location. As a result, a GE prevalence of 65.7% was found, with a unique statistically significant association between GE and the fixed apparatus time use, where those patients who used it for more than 12 months, had a higher risk (p= 0.0039; OR: 3.42; 95% CI: 1.46-8.02). Grade I GE (papillary) was the most prevalent; vestibular surfaces and lower anterior teeth were the most frequent locations.