Root coverage can be achieved by many techniques. In this case report a patient was treated with a connective tissue with partial thickness double pedicle graft, which resulted in complete root coverage. However, 6 days postsurgery the patient developed a bleeding problem from the palatal donor area. For this reason, a unique approach was used to treat the next area needing root coverage. The procedure combined an acellular dermal matrix and a coronally positioned pedicle. The procedure was used to treat 3 defects. Complete root coverage was obtained on 2 of the 3 defects. The third was covered to within 1 mm of the cemento-enamel junction (CEJ). Histology showed similar results with a connective tissue graft and an acellular dermal matrix. Verhoeff's staining demonstrated that the acellular dermal matrix was incorporated into the gingival tissue. This case report demonstrated that acceptable results can be obtained with the connective tissue with partial thickness double pedicle graft and the acellular dermal matrix combined with a coronally positioned pedicle, both clinically and histologically. J Periodontol 1998;69:1305–1311.