Background: Vitiligo is a chronic autoimmune skin disorder characterized by depigmented regions of the skin caused by a loss of melanocytes. Although the origin of vitiligo is yet unknown, environmental, immunological, and genetic factors are involved. In the treatment of vitiligo, microneedling is an effective adjuvant that improves the administration and effectiveness of medications such as trichloroacetic acid, 5-fluorouracil, and latanoprost. There is currently little data regarding the combination that is both safe and effective. This study aimed to compare the efficacy of microneedling delivery of latanoprost versus microneedling delivery of 5-fluorouracil and microneedling delivery of Trichloroacetic acid 35% in induction of skin re-pigmentation in stable vitiligo. Methods: This non-randomized controlled clinical trial was conducted on 54 patients, 18-60 years old, with stable vitiligo. They were divided into; Group (A) patients treated with dermapen followed by 5% 5-fluorouracil, Group (B) patients treated with dermapen followed by latanoprost and Group (C) patients treated with dermapen followed by Trichloroacetic acid 35%. Results: There was an increase in excellent response among group compared to B&C but without statistical significance. Also, there was no statistical significance difference between the studied groups in time of starting response. There was an increase in frequency of very satisfaction among group A compared to B&C but without statistical significance. Conclusion: The combination of microneedling with either 5-Flourouracil or latanoprost or Trichloroacetic acid 35% is safe and effective in treatment of localized stable vitiligo. The degree of improvement was higher with 5- fluorouracil than latanoprost and Trichloroacetic acid 35%.