Background: The purpose of the present study was to evaluate the clinical efficacy of free rotated papilla autograft technique combined with coronally advanced flap and coronally advanced flap alone on other side using the microsurgical techniques in root coverage procedures and to compare the efficacy of these two surgical therapeutic modalities in the treatment of localized gingival recession. Method: 20 patients showing Miller’s class I and class II type of localized gingival recession on the contralateral sides were selected and assigned randomly into experimental site A (free rotated papillary autograft combined with coronally advanced flap) and experimental site B (coronally advanced flap.) using microsurgical approach, according to the split-mouth design. The clinical parameters recorded were Plaque Index, Gingival Index, Recession depth, Recession width, Probing depth, Clinical attachment level, and Width of keratinized gingiva at baseline and 12 months post-operatively. Results: All parameters improved from baseline to 12 months. The mean plaque index at baseline was 0.89 ± 0.11 which was reduced to 0.62 ± 0.11 at 12. The mean gingival index at baseline was 0.73 ± 0.12 which was reduced to 0.46 ± 0.12 at 12 months. Conclusion: Both groups showed adequate amount of coverage of recession sites.However on comparison between the two groups, the mean difference in clinical parameters between the two procedures showed no statistical significance.