Background: Vitiligo is a dermatological disorder characterized by functional melanocyte loss, affecting 1% of the global population. The prevalence and impact of thyroid hormone and autoantibody levels on pediatric patients with vitiligo remain unclear. Aim: This study aims to assess the incidence of autoimmune thyroid disorder in pediatric vitiligo patients and investigate the impact of thyroid hormone and autoantibody levels on vitiligo activity. Subjects and Methods: A total of 68 children with vitiligo participated in this cross-sectional study, which included measurements of thyroid function, autoantibody tests, and examinations of the patients' vitiligo type, duration, activity, and onset. Results: Autoimmune thyroiditis was detected in 33.8% of patients. Positive anti-thyroglobulin antibodies were significantly associated with a family history, duration, and activity of vitiligo. Positive anti-thyroid peroxidase antibodies were significantly related to active vitiligo, sudden onset, and higher TSH levels. Anti-thyroglobulin antibodies correlated positively with age, duration, and TSH levels but negatively with T3 and T4 levels. Anti-thyroid peroxidase antibodies were positively correlated with TSH. Positive anti-thyroglobulin antibodies extended disease duration. Active vitiligo and rapid onset were more frequent with positive anti-thyroid peroxidase antibodies. Conclusions: This study concluded that pediatric vitiligo patients, particularly females and those with a family history of autoimmune diseases, have a higher frequency of thyroid dysfunction and autoantibodies. Moreover, regular monitoring of thyroid function and autoantibodies among pediatric patients with vitiligo is important to detect progression to overt hypothyroidism. Consequently, practitioners should recognize and treat thyroid-related conditions early and be aware of the relationship between vitiligo and autoimmune thyroid disease.