Background Severe androgenetic alopecia has significant impact on patients’ self‐image and emotional health. As the most advanced way to achieve the growth of a full head of hair in shortest period of time, the megasession hair transplant procedure is a promising treatment for severe androgenetic alopecia. Aims To introduce the procedure and technical details of follicular unit extraction megasession and to evaluate the surgery outcome. Method A total of 273 male patients undergoing follicular unit extraction (FUE) megasession between 2016 and 2018 were included in our study. The extraction was performed using 1.0 mm punch. The BASP classification degree of patient hair loss, the number of extracted hair, surgery consuming time, and graft survival rate were recorded. We finally evaluated patients’ satisfaction with surgery outcomes. Results Ages of patients ranged from 28 to 53 years, with a mean of 42 years (SD, 8.42). All of them were at C3 and U1 degree of BA type hair loss according to the BASP classification. The number of follicular units transplanted was between 3000 and 6000, with surgery duration range from 6 hours to 12 hours and graft survival rate varies from 93.5% to 96.6%. A total of 81% of them were satisfied with the outcomes, 19% of them had a second procedure performed to provide further hair density. None of them had infection after the surgery. Conclusion Compared with multi‐stage hair transplantation, FUE megasession has the advantages of reducing operation frequency and overall surgery duration. Thus, FUE megasession is an appealing treatment option for severe AGA patients, who expect to a more desirable natural and esthetically pleasing result in a one‐stage operation.