Background: Vitiligo is a skin disease with complex, multifactorial pathogenesis. Abnormalities in surrounding keratinocytes may cause melanocyte death due to deprivation of growth factors. Objective: To evaluate Haematoxylin and Eosin (H&E) histopathological findings in lesional and perilesional vitiliginous skin. Patients Methods: Lesional skin biopsies were taken from 18 vitiligo patients. Perilesional biopsies were taken from 5 patients. All biopsies were stained with Hematoxylin and Eosin for histopathological assessment. Results: Detected changes in lesional skin included increased epidermal thickness, epidermal atrophy, focal disruption of dermoepidermal junction and vacuolar degeneration with focal degree. All examined sections showed congested blood vessels and scanty melanin pigment. Dermal perivascular lymphocytic infiltration was present in all cases. Detected changes in perilesional skin included increased epidermal thickness, epidermal atrophy, plenty of melanin pigment and focal vacuolar alteration. All examined sections showed congested blood vessels and focally disrupted dermoepidermal junction. Dermal perivascular lymphocytic infiltration was present in all sections. Conclusion: Histopathological changes occur in perilesional as well as lesional vitiligo skin. Therefore, topical or physical treatment for vitiligo should be extended to the surrounding apparently normal skin. This may help in arresting disease course by preventing subclinical or silent lesions from progression to clinically visible lesions.