Background: One of the most prevalent skin disorders is vitiligo, which causes the skin to lose its color. Only patients whose vitiligo has not responded to medicinal treatment and whose condition has stabilized should consider surgical intervention. The goal of vitiligo microneedling is to produce cytokines and growth factors that are helpful for repigmentation, in a manner analogous to the wound healing response. Objective: review of the literature on surgical therapies and micro needling roles in treatment of Vitiligo. Methods: We looked for data on Surgical Therapies, Micro needling and Vitiligo, in medical journals and databases like PubMed, Google Scholar, and Science Direct. However, only the most recent or extensive study was taken into account between February 2005 and March 2021. References from related works were also evaluated by the writers. There were not enough resources to translate documents into languages other than English, hence those documents have been ignored. It was generally agreed that documents such as unpublished manuscripts, oral presentations, conference abstracts, and dissertations did not qualify as legitimate scientific study. Conclusion: Only patients whose condition is stable despite medicinal therapy attempts undergo surgical procedures. Better effects have been shown in segmental rather than generalized vitiligo, therefore they are often reserved for hard-to-treat areas like the hands, feet, lips, and nipples. The combination of microneedling with a number of topical treatments, including Tacrolimus and 5-fluorouracil, has shown promising repigmentation outcomes.