Background: Vitiligo is a common depigmenting disorder which may havedevastating psychological and social consequences. The exact cause is stillunknown but autoimmunity is highly implicated in the pathogenesis. T regulatorycells are among the cells that control autoimmunity.Objective: Is to estimate the level of Foxp3 which serves as the dedicatedmediator of the genetic program governing Tregs development and functionwhich has questionable immunomodulatory function in vitiligo, aiming toverify the possible role of them in the pathogenesis of such disease.Methods: The present case controlled cross sectional study included 40 vitiligopatients and 40 age and sex matched healthy controls. Presence of any systemic ordermatological disease affecting the immune system as well as receiving anysystemic or topical immunomodulatory treatments for 3 months prior to the studyprecluded participation. After history taking & clinical examination, a 5 ml bloodsample was retrieved from each patient and control to determine the level of Foxp3gene expression by quantitative real time PCR.Results: The mean level of Foxp3 was found to be significantly lower in thevitiligo patients (0.39±0.29) in comparison to the healthy control subjects(1.48±0.50) (p˂0.0001). The non-significant (p˃0.05) least levels were reportedamong the segmental type, as well as in those with a progressive disease, and inthose with a positive family history. Concerning the relationship between Foxp3and stress a significantly lower value was reported with presence of stress (p˂0.05) and a negative correlation was observed between Foxp3 and the presence ofstress as a precipitating factor (r = -0.45, p = 0.004). Conclusion: The current study demonstrates the diminishing T reg cells to beanother important player sharing in the complex pathogenesis of vitiligo. It hasbeen shown to be associated with a less favorable prognosis of the dise