AimThis study was to evaluate the association between peri-implant bleeding on probing in peri-implant diseases and its association with multilevel factors (site specific factors, implant factors, and patient level factors).MethodologyA cross-sectional study involved consented adult patients with ≥ 1 dental implant. Two calibrated operators examined the patients. BoP was outcome variable and peri-implant gingival biotype was principal predictor variable. The effects of site, implant, and patient level factors on BoP were assessed using a multilevel logistic regression model.ResultsEighty patients for a total of 119 implants and 714 sites were included in the study. Bleeding on probing was observed in 42 implants (35.29%) with a significant higher risk observed in presence of gingival recession, thin peri-implant gingival biotype, duration of implant placement, smokers, and male patients.ConclusionPeri-implant bleeding on probing was associated with site specific, implant, and patient level factors.