Aim: The objective of this study is to determine the frequency of morphological changes in distinct median maxillary labial frenum among patients presenting to a tertiary health care center in Ernakulam, Kerala. Additionally, gender and age differences in frenal morphology were examined. Materials and methods: The study was conducted during the period from February 2022 to January 2023 among people who visited a tertiary health care center in Ernakulam and above, after obtaining official permission from the Institutional Ethics Committee of Amrita Institute of Medical Sciences (IRB-AIMS-2020-110). The frenum morphology was determined using the direct visual method under natural light by reflecting the upper lip with the index finger and thumb of both hands. The examination was conducted by two investigators who were calibrated. The morphology was then determined based on the classification by Mohan et al. Results: Out of 350 participants studied, 70% had the simple frenum major type. The Chi-squared test values obtained for gender and age were 0.72 and 0.55, respectively, which signify that the frenal morphology variation with respect to age and gender is minimal. Conclusions: The major simple type of frenum was the most common among the people who visited a tertiary health care center in Ernakulam. The single subtype of simple frenum was the most common type of simple frenum. Clinical significance: Attachment variations can affect oral hygiene maintenance, leading to gingival recession, black triangles (midline diastema), and affecting prosthesis retention. Having a sound knowledge regarding these variations is significant in diagnosis and treatment planning and ought to be taken into consideration.