Drug-induced gingival enlargement (DIGE) is an abnormal gingival overgrowth caused by specific medications. Its management requires multidisciplinary collaboration to adjust the causative drugs and implement sequential periodontal therapy, with the ultimate goal of restoring normal gingival conditions and maintaining oral health. This report describes a patient with DIGE after kidney transplantation and hypertension. Through standardized initial periodontal therapy combined with periodontal surgery and long-term supportive periodontal care, gingival enlargement was effectively reduced and oral function was restored. During four years of follow-up, no extensive recurrence of gingival enlargement was observed, and satisfactory functional and esthetic outcomes were achieved. Multidisciplinary collaboration and continuous follow-up are crucial for reducing the risk of recurrence and may provide a reference for the diagnosis and treatment of similar cases.