OBJECTIVES: Root coverage(RC)is an integral part in management of gingival recessions. Unlike isolated recessions, treating multiple recessions is the most challenging scenario especially in smokers who have reported reduced RC in terms of quantity and stability. Modi ed coronally advanced tunnel(MCAT) technique due to its improved vascularity along with use of porcine-derived collagen matrix (PDCM) (Mucograft™) with its bilayered dense collagen matrix may be a predictable alternative to conventional gold standard subepithelial connective tissue graft(SCTG). The purpose of this study was to compare the results of RC achieved using PDCM and SCTG with the MCAT approach in the treatment of multiple gingival recessions in smokers.METHODOLOGY: This is a prospective randomized controlled clinical study registered under clinical trial registry (CTRI no. CTRI/2020/03/024238) including 28 patients with 64 recession defects. Patients were randomized into SCTG and PDCM groups which were treated with SCTG using MCAT and PDCM using MCAT technique respectively. Recession depth(RD), Recession width(RW), Width of keratinized tissue(WKT), Thickness of keratinized gingiva(TKG), %RC, were assessed at baseline,3,6 months. Complete RC(CRC) at 3 and 6 months, RC esthetic scores(RCES) at 6 months. RESULTS: Both groups showed signi cant improvement in all clinical parameters. Intergroup comparison showed better performance of PDCM group in terms of RD,%RC,TKG,WKT,CRC(45.06%),RCES (p<0.001) compared to SCTG group. Time taken for surgical procedure and Visual Analog pain scores were signi cantly lesser in PDCM group. CONCLUSION: PDCM showed good predictable results in terms of all RC parameters compared to SCTG and thus may be used as a predictable alternative to SCTG for RC in smokers.