BackgroundTo evaluate and compare efficacy of pinhole surgical technique (PST) alone and with advanced platelet rich fibrin (A‐PRF) in the management of bilateral multiple adjacent gingival recession defects (MAGRD).MethodsOne hundred and sixty five MAGRD were randomly assigned to control group (treated with PST) and test group (PST with A‐PRF). Clinical parameters of gingival recession depth (GRD), gingival recession width (GRW), width of keratinised gingiva (WKG), complete root coverage (CRC) and gingival thickness (GT) on ST‐CBCT was measured at 2, 4 and 6 mm apically from the gingival margin. Also, root coverage aesthetic score and patient satisfaction ratings were recorded at baseline, 6 and 12 months postoperatively.ResultsSubstantial reduction in GRD (Test: 1.29 ± 0.69 mm and Control 0.98 ± 0.30 mm) (p < 0.001) and GRW (Test: 2.03 ± 0.90 mm and control 1.73 ± 0.99 mm) (p < 0.05) with associated gain in WKG and GT was observed (p < 0.001). Mean GT values were increased in both the groups at 2, 4 and 6 mm from the crest. Comparison of Test and Control groups yielded significant reductions in GRD (−0.17 ± 0.56 mm) and WKG (0.73 ± 1.07 mm) favoring the Test group (p < 0.05). Similar increase in GT was observed with better results in Test than control group. (p < 0.001).ConclusionBoth groups exhibited sound clinical outcomes with test group offering better resolution of MAGRD in comparison to control group. Also, it enhances clinical and therapeutic end results in terms of attaining reduction in GRD and GRW along with greater gain in KTW and GT.Clinical SignificancePST as a minimally invasive approach has numerous benefits, some of which include the absence of scarring and improved aesthetics linked to faster wound healing. The addition of A‐PRF enhances the intended therapy outcomes, which is beneficial for both patients and professionals in the field of periodontics.