Background: Rosacea is a chronic skin condition that primarily affects the central face, and is often characterized by flare-ups and remissions. The increase in serum vitamin D levels is associated with rosacea. Rosacea may be happened due to high level of vitamin D that increases level of cathelicidin, which affect inflammatory process and vascular response. In the other hand Ca level does not have relationship to the cause of rosacea. Objective: To investigate the relationship between serum vitamin D and calcium levels in patients with rosacea and analyze the association of vitamin D with clinical features. Patient and methods: This prospective case control study was carried out on thirty patients with rosacea and twenty age and gender matched healthy controls. All enrolled participants were subjected to a full history taking, general and detailed dermatological examination. Results: Rosacea group showed significantly higher mean vitamin D level when compared to control group (25.5±5.3 versus 17.7±5.2) (p < 0.001). Rosacea cases had 17 with optimal vitamin D levels and 13 with mild to moderate deficiency, while control group cases had 4 with optimal vitamin D level and 16 with mild to moderate deficient vitamin D levels. There was significant (p=0.010) difference between cases and controls regarding vitamin D status. Total and ionized calcium levels did not differ significantly (p= 0.662 and 0.888 respectively) between cases and control groups. Conclusion: Increased vitamin D levels may lead to the development of rosacea. New findings can be increased the understanding of pathogenesis of rosacea and may lead to development of new treatment options for rosacea.