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Background: Alopecia areata (AA) is a type of alopecia that does not leave scars and can affect any portion of the body or scalp. It accounts for 25% of all cases of alopecia, making it one of the most prevalent causes of hair loss treated by dermatologists. Psychosocial stigmatization makes it hard for AA patients to advocate for better medical care and treatment. To treat AA, azathioprine can be used as an effective alternative therapy, and it can be introduced early on in the treatment timeline. In the treatment of inflammatory and immune-mediated skin problems, methotrexate is a common conventional immunosuppressant. The objective of this review is to assess the possible role of both Azathioprine and methotrexate in Management of AA. Development: Azathioprine and methotrexate were all looked for in PubMed, Google scholar, and Science direct. References from relevant literature were also evaluated by the authors, but only the most recent or complete study from March 2010 to May 2021 was included. Due to the lack of sources for translation, documents in languages other than English have been ruled out. Papers that did not fall under the purview of major scientific investigations, such as unpublished manuscripts, oral presentations, conference abstracts, and dissertations, were omitted. Conclusion: Methotrexate as well as azathioprine can be considered an effective monotherapy or adjunctive for treating alopecia areata.