A prerequisite for any type of restoration or replacement prosthesis is to be in harmony with the adjacent periodontal tissue and have no harmful effect on its health. Objective: To assess the effect of fixed prosthesis design on health of periodontal tissue. Methods: By using a pre-structured proforma for this observational descriptive study, during the period from September to December 2021, data were collected from sample subjects at Peshawar Dental College and Hospital, Peshawar. A total of  175 (93 females, 82 males) subjects of different ages, were selected with a pre-determined inclusion and exclusion criteria. Different variables, such as gingival index, probing pocket depth, margin location of crown / bridge and proximal contact between crown/bridge with adjacent teeth were assessed via William’s Probe. The data were analyzed with SPSS version 22. Results: All of the 175 subjects had fixed Prosthesis for 10 years or less, among these, 95 received Crown and 80 received Bridge as Fixed Prosthesis. Among these 58 % had Sub-gingivally placed crown margin, 38 % had equi-gingival, while 3 % had Supra-gingival, whereas, 57% of this prosthesis had a tight proximal contact while 42% had an open proximal contact with the adjacent tooth. 55% showed high level of severity for developing Localized periodontal issue at the site of abutment after the insertion of prosthesis, where as 44% developed localized gingivitis at the site of abutment. Conclusion: It was concluded that  high score of gingival index and probing depth were recorded for subgingival finish line location and discrepancies in proximal contact points.