Objective: To compare the e cacy of topical minoxidil and platelet-rich plasma (PRP) in the treatment of alopecia areata (AA). Study Design: Randomised control trial. Place and Duration of the Study: Department of Dermatology, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from December 2021 to June 2022. Methodology: The study included all the patients who visited JPMC Karachi during the study period. Permission from the ERB was obtained. The inclusion criteria were any gender and age 10 to 45 years. Topical minoxidil 5% solution was applied twice daily to Group A (six pubs/time), while PRP injections were administered to Group B at baseline and every four weeks for three months. Serial photos and the severity of alopecia tool (SALT) were used to determine the clinical assessment. When comparing the e ectiveness between the two groups, a p-value of <0.05 was considered signi cant. SPSS version 23 was used to analyse the data. Results: Mean age was 23.11 ± 8.9 years in 376 patients. PRP and Minoxidil groups had mean SALT scores at three months that were 1.48 and 1.54, respectively. Both treatments were shown to be e cacious. There was no statistically signi cant di erence in e cacy between the minoxidil solution and PRP (p = 0.483). Conclusion: There is no apparent di erence between PRP and topical minoxidil 5% solution in the management of AA. To verify the results, additional studies are needed with a larger sample size and a longer duration of follow-up.