Recessive Robinow syndrome (RRS) is an extremely rare short stature genetic condition with significant and characteristic oral, dental, and facial attributes that generally requires coordinated multidisciplinary dental and medical interventions. This paper describes the clinical findings and dental management over the course of 4 years of a US-born Caucasian female with recessive Robinow syndrome who presented to our dental clinic at age 11 years, 0 months and who is now age 15 years, 3 months. Of special interest was the extent to which the patient's hyperplastic gingival tissues impeded both normal tooth eruption and orthodontic tooth movement.