Background: Alopecia areata is a common autoimmune disease that encountered world-wide. Many modalities have been used but no one was universally effective. Zinc sulphate has been used in the treatment of many skin diseases.Objective: To establish the effectiveness of oral zinc sulphate in the treatment of patchy alopecia areata Patients and Methods: Patients with alopecia areata who attended the Department of Dermatology-Baghdad Teaching Hospital was recruited into randomized, placebo-controlled, double-blind cross-over trial between February 2008 and September 2009. Patients were randomly allocated to receive either zinc sulphate 5mg /kg/day in three divided doses (Group A) or identical placebo capsules (Group B). Zinc sulphate and placebo capsules were given in a double-blind manner, following 3 months of starting the treatment, the patients crossed over, i.e. patients on zinc sulphate shifted to placebo and vice versa. Results:One hundred patients (60 males and 40 females) with patchy AA met the inclusion criteria and enrolled for the study. Sixty-seven patients completed the study, 41(61%) males and 26 (39%) females, their ages ranged from 1.6 -68 (22.031 ± 14.8505) years. Duration of the disease ranged from 1 -48 (14.4 ±14.8875) weeks. In group A, at the end of third month, complete hair re-growth with terminal hairs have been obtained in 22 (59.45%) patients. After shifting to placebo treatment the hair continued to grow without relapse and at the end of sixth month, the complete hair re-growth was occurred in 23(62.16%) patients. In group B, at the end of third month, complete hair re-growth had been obtained in 3 (10%) patients. While, after shifting to zinc sulphate the complete hair re-growth obtained in 20 (66.67%) patients. No important side effects were reported apart from mild gastric upset in 8 (11.9%) patients. Conclusion:Oral zinc sulphate is one of the effective treatment options for AA with low relapse rate after stopping of the treatment.