Background: Gingival overgrowths has been well reported, however its behavior has not received much research attention in Nigeria. This study assessed the prevalence, pattern and distribution of gingival overgrowths in a cosmopolitan city in Nigeria in a retrospective study of 140 patients seen between 2006 and 2020 at the Dental centre of the Lagos state University Teaching Hospital Ikeja Lagos Nigeria. Histopathologic reports were accessed from the Oral Pathology department of the same institution. The demographics and distribution of the lesions were noted from the records. SPSS 21 was used, descriptive statistics was carried out for both continuous and categorical variables. Relationship between the diagnoses and the independent variables, and also of tooth mobility were carried out using Pearson’s chi square, significance was determined at p≤0.05. Female/male ratio was 2.2:1 and mean age was 36.6±17.7. Prevalence of gingival overgrowth was highest among the 31-40 year olds. The anterior sextant of the maxilla and the buccal/labial location were commonest sites. Pyogenic granuloma has the highest prevalence of 62.9%, 57.2% of the lesions were pedunculated while 38.6% were associated with tooth mobility. There is statistically significant relationship between the histological diagnoses and the age groups, nature of the lesions and tooth mobility (p<0.05). Pyogenic granuloma was higher in this study than elsewhere, the strong relationship with age, high rate of recurrence of some and malignant lesions which may mimick reactive gingival lesions regardless of the age of the patients seen in this study demands further research and careful note in diagnosis and management.