Background: Full-coverage crowns are a common restorative treatment option; yet, their placement may influence gingival health and tissue response. This study aims to assess the changes in gum health around crowns after placement and at one-year follow-up. Methods: A prospective study was conducted in the Department of Prosthodontics, Faculty of Dentistry, Bangladesh Medical University, from January 2002 to December 2003. Thirty patients requiring full coverage crowns were included and followed. Clinical parameters like plaque adhesion, probing depth, gingival bleeding, gum recession, and metal margin exposure were recorded at 15 days and one year after cementation. Data analysis was done using SPSS version 26 with statistical significance at p<0.05. Results: In 30 patients (53.3% male, 46.6% female), no plaque was observed immediately following the placement of the crown, but 33.3% of them exhibited plaque deposition at one-year follow-up (p=0.100). Probing depth, which was 1-1.5 mm in 100% of cases at 15 days, rose to 66.66% with 1-1.5 mm depth and 33.33% with <2 mm depth at one year. Gum recession was not observed initially, but was present in 60% of cases at one year. Metal margin exposure was increased from 0% to 50% at one-year follow-up. Conclusion: The study confirms that gingival tissues accommodate by developing changes after full coverage crown placement, where greater plaque build-up, gum recession, and metal margin exposure were observed at one-year follow-up. Ongoing vigilance and upkeep are unavoidable if the long-term success of crown restorations is to be ensured.