Alopecia areata (AA) is a common, acquired, non-scarring hair loss characterized by possible spontaneous regrowth and relapses. It is characterized by circular, well-circumscribed, patchy area of hair loss without any signs of inflammation and scarring. In some cases, patches may become confluent leading to total scalp hair loss (AA totalis) or complete scalp and body hair loss (AA universalis). Dermatoscopy represents a very useful technique both for diagnostic purposes and therapeutic monitoring. Dystrophic hair shafts, which may appear as exclamation-mark hairs (the most specific sign of acute alopecia areata), broken hairs, and black dots, are indicative of anagen alterations and correlate with strong disease activity. Yellow dots are commonly seen both in acute and chronic forms. Vellus hairs represent an early sign of regrowth.