Objectives <p>To evaluate the efficacy and safety of cryogun cryotherapy in treating benign oral vascular anomalies (BOVAs).</p> Materials and methods <p>We conducted a retrospective longitudinal study on patients with BOVA who underwent cryogun cryotherapy. The clinical outcomes assessed included lesion regression, recurrence, complications, and clinical predictors of prognosis.</p> Results <p>Cryogun cryotherapy demonstrated high efficacy in treating BOVA in a study of 33 patients, with 97% of lesions achieving complete regression after an average of 1.64 ± 0.93 sessions (range: 1–4). Treatment outcomes were influenced by factors such as lesion morphology and anatomical location. Lesions in the buccal mucosa required more sessions compared to other anatomical sites, and exophytic lesions necessitated more sessions than flat lesions.</p> Conclusions <p>Cryogun cryotherapy is a safe and effective treatment option for BOVA, regardless of lesion size or location. Residual lesions can be treated successfully with additional sessions.</p> Clinical relevance <p>Cryogun cryotherapy offers a reliable prognosis for BOVA patients and provides a cost-effective, non-invasive alternative to other treatment methods.</p>