The final goal of periodontal treatment is to achieve functional and anatomical tissue regeneration. Numerous techniques have illustrated favorable effects on anatomical and functional periodontal regeneration, but long-term results are highly variable. In addition, techniques for closure of class I-II recessions have results up to 100% with high predictability, in contrast to Miller class III-IV recessions, according to the literature. This systematic review aims to define the different techniques for closure of Miller class III-IV recessions and to identify their characteristics in different clinical situations. A study of publications in the electronic databases PubMed, Google Scholar and eLIBRARY was performed through a literature review. Articles concerning various techniques for closure of class III-IV recessions were included. A total of 100 articles were reviewed during the revision process. After analyzing the literature according to the inclusion criteria, the final number of articles had become 46. The features of the various techniques as well as long-term surgical outcomes were reviewed. Many techniques should be further investigated, due to insufficient clinical data and a few number of cases. © (2023), (University of Dicle). All Rights Reserved.