Vitiligo affects approximately 0.5% of the global population, with prevalence peaks in specific regions. Historically misdiagnosed as leprosy, it has carried significant social stigma since ancient times. The earliest reference to vitiligo appears in the Iranian text “Tarkh e Tibble” (2200 BC), and the term was first used by the Roman physician Celsus. Social ostracism associated with vitiligo persists, necessitating patient reassurance about the disease’s nature. Vitiligo’s pathophysiology involves the progressive loss of melanocytes, leading to depigmented patches. It is classified into segmental, non-segmental, focal, mixed, and indeterminate types, with segmental vitiligo typically presenting earlier. Theories of vitiligo’s aetiology include neurogenic, self-destruction, and autoimmune hypotheses. Differentiating vitiligo from other hypopigmentary disorders is essential for accurate diagnosis. Wood’s lamp examination and biopsy support diagnosis and differentiation. Non-segmental vitiligo often exhibits a pattern of abrupt onset, stability, and rapid evolution, with rare spontaneous repigmentation. Segmental vitiligo, frequently involving hair follicle melanocytes, responds better to surgical treatments. Management requires a comprehensive approach, addressing medical, psychological, and social aspects. Therapeutic options include aggressive treatments like steroids and JAK inhibitors for rapidly progressing cases, and various surgical techniques for stable disease. Advances in topical therapies and light-based treatments offer hope for improved outcomes. In summary, vitiligo, an ancient disease now better understood, requires a holistic management approach integrating medical, psychological, and social support to improve patient outcomes and quality of life. Ongoing research promises more personalized and effective treatments for those affected by vitiligo.