Vitiligo is an autoimmune disease characterized by the presence of depigmented macules over the body. It may have a significant effect on the quality of life and may cause psychological distress to the patient, especially in skin of color. The treatment of vitiligo is aimed at halting the progression of the disease, repigmentation of depigmented patches, and prevention of recurrence. Various treatment modalities used in the management of vitiligo include topical agents, systemic therapies, and phototherapy. These therapies may be used alone or in combination depending on various factors like body surface area involved, age, sites involved, progression of the disease, presence of comorbidities, availability of the treatment, etc. Systemic immunomodulatory and immunosuppressive agents are used in patients with slowly or rapidly progressive disease and patients with extensive body surface area involvement. These immunosuppressive and immunomodulatory agents include corticosteroids, azathioprine, methotrexate, cyclosporine, mycophenolate mofetil, cyclophosphamide, zinc, levamisole, and minocycline. Out of all these agents, systemic corticosteroids in the form of oral mini pulse are most commonly used. Azathioprine and methotrexate may be used when corticosteroids are contraindicated. The definitive role of zinc, levamisole and cyclophosphamide in vitiligo is yet to be proven.