Background: Alopecia areata (AA) is the second most frequent nonscarring alopecia after androgenetic alopecia; the trigger factor induces changes in the growth plate of hair bulb and leads to premature termination of anagen phase. Epidermal growth factor (EGF) can be the key molecule that participates in initiation and suppression of normal hair growth cycle. The role of EGF in the pathogenesis of AA is still uncertain. Aim of the Work: This aim is to estimate the serum level of EGF in patients with AA trying to detect its role in AA pathogenesis and correlate it with the disease severity. Subjects and Methods: This case–control study included 60 clinically diagnosed patients with AA with different variants and severities and 25 age- and sex-matched healthy controls. EGF level was measured using ELISA. Results: The mean serum EGF was statistically significantly higher in patients than of controls ( P < 0.0003). The EGF level was higher in patients with disease duration >1 month than patients with disease duration ≤ 1 month, and it was higher in patients with high recurrence than patients without recurrence ( P > 0.05). The EGF in patients of severe AA was statistically significantly higher than moderate AA patients, and moderate cases were higher than mild AA patients ( P = 0.0001). Furthermore, the level of EGF with scalp involvement was higher; the highest serum level of EGF marker in S4 (75%-99%) hair loss then S3 (50%-74% hair loss), illustrated in table (4) followed by different percentage of hair loss, difference statistically significant. Conclusions: Elevated hair-specific growth factor as EGF is not always a good sign for hair growth and functioning promotor inducing hair recovery, but it may be linked to the pathogenesis of hair disorders as AA.