Management of gingival overgrowth due to medication is bothersome because plaque control measurement alone did not prevent gingival overgrowth. The best treatment of drug induced gingival overgrowth is discontinuing use of the associated drugs. In this report we attempt to evaluate the short term effects of azithromycin which shown to be of some benefit on gingival overgrowth due to medication. We studied 16 organic transplanted patients who had the gingival overgrowth. All patients received oral azithromycin once daily for 5 days. We measured papillary overgrowth index(POI) every interdental areas before treatment and after 2 and 4 week. Severity and frequence of the papillary overgrowth is tend to reduce progressively in 2 to 4 weeks after treatment in all patients. But no case is completely resolved within 4 weeks. We could find the partial resolution of gingival overgrowth with a 5 day treatment of azithromycin. It is not known whether the response to azithromycin was mediated through its antibacterial effect or another mechanism. We suggest that the treatment of azithromycin could be added to periodontal management of patients with gingival overgrowth due to medication.