Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a rare gingival lesion predominantly affecting individuals aged <20 years. Although it has a distinct clinical presentation, its underlying pathogenesis remains poorly understood and standardized treatment guidelines are yet to be established. Surgical excision is the most common treatment; however, concerns regarding recurrence, aesthetic impact, and patient cooperation, particularly in pediatric cases, highlight the need for alternative approaches. Although spontaneous regression of LJSGH has been suggested, well-documented cases are rare. This report presents a case of LJSGH demonstrating spontaneous resolution without surgical intervention. A lesion on the mandibular anterior facial gingiva fully resolved over a 32-month period, further supporting the potential for natural resolution, and emphasizing the need for a conservative management approach.