Background: Gingival esthetics was considered one of the most significant aspects of aesthetic smiles, especially in those with gingival hyperpigmentation. Understanding the features, distribution, and causes impacting gingival pigmentation was critical for developing an effective treatment plan. Objectives: The prevalence of gingival hyperpigmentation in outpatients at Can Tho University of Medicine and Pharmacy Hospital; the association between gingival hyperpigmentation and age, gender, smoking status, and skin color. Material and Methods: Descriptive cross-sectional method; convenience sampling. Results: In a total of 100 outpatients, the rate of gingival hyperpigmentation was 53%, of which 40% had mild gingival hyperpigmentation according to DOPI (grade 1), 13% had moderate gingival hyperpigmentation (grade 2), and 13% had heavy gingival hyperpigmentation disease (grade 3). The study collected 3/6 groups of gingival melanin hyperpigmentation according to Ponnaiyan's classification. Of all the hyperpigmentation groups according to Hedin's classification, the hyperpigmentation group forming a long continuous ribbon accounted for a high proportion (45% in the maxilla, 40% in the mandible). The rates of gingival hyperpigmentation in the group of 40-year-old patients and the others were 48.8% and 75%, respectively. Conclusion: There was a statistically significant relationship between gingival melanin pigmentation and skin color. The percentage of melanin pigmentation was higher in those with dark skin. There were no differences in the ratios for age, gender, or smoking status.