Objective To observe the effect of free gingival graft (FGG) on the repair of soft tissue defects after epulis resection. Methods Forty patients with epulis who were treated in Nanchong Central Hospital from March 2021 to March 2023 were randomly divided into control group and observation group, with 20 patients in each group. The control group was treated with coronally advanced flap (CAF), and the observation group was treated with FGG. The pain degree at 1 week after operation, keratinized gingival width (KGW) at 3 months after operation, bleeding index (BI) at 1 week after operation and aesthetic effect of gingival morphology at 3 months after operation were compared between the two groups. Results There was no significant difference in VAS score and BI between the two groups (P >0.05). The KGW of the observation group was higher than that of the control group, and the aesthetic effect of gingival morphology was better than that of the control group (P <0.05). Conclusion Both FGG and CAF can repair soft tissue defects after gingival tumor resection, but FGG has better effect on restoring gingival morphology and higher technical sensitivity. If the keratinized gingival width of patients is small, FGG can be selected for repair.