Aim: The aim of this study was to evaluate and compare the therapeutic efficacy of microneedling and microneedling combined with topical 5- fluorouracil. Materials and Method: Twentyfive patients with localized stable vitiligo were treated in each group. Microneedling alone was done in control group where as in study group microneedling combined with topical 5- fluorouracil was used which is available in form of solution with concentration of 50mg/ml. The procedure was repeated after every 15 days upto 6 months and the patients were followed up to 9 months. Results: The efficacy of treatment was higher (67.24%) and rapid in lesions treated with microneedling combined with 5-fluorouracil compared with microneedling (26.66%) alone. Conclusion: Microneedling combined with 5-fluorouracil is efficient and a better treatment in localised stable childhood vitiligo.