Introduction <p>Vitiligo is an autoimmune, depigmenting skin disease affecting 0.1–1.6% of adults in the USA. Despite observed correlations between vitiligo and other autoimmune conditions in global patient populations, a focused review of comorbidities in US patients with vitiligo is lacking. This systematic literature review and meta-analysis evaluated the prevalence of autoimmune comorbidities in adult patients with vitiligo in the USA.</p> Methods <p>A systematic literature search of the PubMed and Embase electronic databases (January 1, 2012–November 30, 2022) selected observational studies reporting data on prevalence of autoimmune diseases in US patients with vitiligo. The Grading of Recommendations, Assessment, Development, and Evaluation approach for prognosis was applied to assess certainty of evidence.</p> Results <p>Eight studies were eligible for inclusion, encompassing 10,246 patients with vitiligo. Thyroid diseases (14.2%), psoriasis (5.1%), rheumatoid arthritis (3.2%), and alopecia areata (2.7%) were among the most common comorbidities by pooled prevalence rates, with the highest certainty of evidence for associations with thyroid disease and alopecia areata. In addition, there was high or moderate certainty of evidence that greater vitiligo extent is associated with increasing prevalence of thyroid disease, type&#xa0;1 diabetes, rheumatoid arthritis, and pernicious anemia.</p> Conclusions <p>There is clear evidence of correlations between vitiligo and select autoimmune comorbidities in US adults despite the limitations of this study, including the small number of available high-quality studies. The findings presented here demonstrate the importance of future longitudinal studies to identify causal links between vitiligo and comorbidities, and to evaluate potential benefits of screening and early management for thyroid disease, rheumatoid arthritis, and other autoimmune comorbidities.</p>