Frenum is a dynamic structure which encompasses a wide range of physiological variations. It is of utmost importance to understand the association between oral hygiene condition and labial frenum attachment, as they play a major role in the maintenance of ginigival health. Abnormal frenal attachment is an important clue in the detection of many syndromes which helps in early identification of the problem and planning the treatment. The present review article covers the Embryology, syndromes associated with frenum and recent advances and various protocols in managing abnormal frenum