Introduction: Vitiligo, a pigmentary disorder, may influence considerably patients health-related quality of life (QoL) and psychological wellbeing. Previous reports indicated that the patients' illness understandings influence adherence behaviors and actions in various chronic dermatological conditions. Objectives:To know the understanding of Nepalese patients with vitiligo about their disease by using illness perception questionnaire and also to investigate the potential factors that might influence it. Material and Methods:The illness perception questionnaire consisting of 25 questions about causes, timeline, consequences and control of disease were given to 154 patients with vitiligo of 13 years or more age attending the dermatology OPD.Results: A total of 146 patients completed the questionnaire. The belief about the causes of vitiligo was considered as germs or virus by 64.4% patients while half of the patients believed that vitiligo was due to chance or fate. Vitiligo was considered to be a serious condition (83.6%) and have had serious consequences on their life (63%). Approximately half of the patients believed that their disease had serious economic and financial consequences more so in female patients and in those with generalized disease. Although 43.8% patients believed that their illness was likely to be permanent rather than temporary, 75% patients believed that vitiligo would improve with the time and their treatments were effective (75.3%). However, females felt that there were very little that could be done to improve their vitiligo. Conclusion:The knowledge about vitiligo is unsatisfactory and needs accessible, accurate, community based education about the natural history of vitiligo and the effectiveness of treatment.