Objectives <p>To investigate creeping attachment after soft tissue augmentation surgery in areas with gingival recession.</p> Materials and methods <p>This study observed sites of gingival recession who underwent soft tissue augmentation surgery. Changes in gingival recession depth (RD), keratinized tissue height (KTH) and gingival thickness (GT) were measured at 1, 3, 6, and 12 months post-surgery. The changes in creeping attachment (CA) and mean root coverage (MRC) were calculated, and the relationship between the increase in GT and CA was analyzed.</p> Results <p>A total of 58 sites in 24 patients were observed. At 1 month postoperatively, RD, KTH and GT improved in all patients with CA of 0.66 ± 0.40&#xa0;mm and MRC of 22.9 ± 13.9%. All indicators further improved from 3 to 12 months post-surgery. There was a positive correlation between the increase in GT and CA from 1 to 6 months post-surgery.</p> Conclusion <p>Significant changes in RD, KTH and GT were observed 1 month after soft tissue augmentation surgery, with all indicators stabilizing by 3 months. The increase of GT was positively correlated with CA, and the phenomenon of creeping attachment was still observed 1 year after the surgery.</p> Clinical relevance <p>The study identified changes in creeping attachment after soft tissue augmentation surgery to help clinicians understand this phenomenon better.</p>