Context:Although the primary cause of premature hair graying (PHG) is considered to be genetic, certain environmental factors also play a role. Trace element deficiencies such as Vitamin B12, Vitamin D3, and calcium may also be associated with PHG. However, India-specific data are relatively sparse.Aims:The present study aimed at identifying factors associated with PHG in Indian patients.Settings and Design:A case–control study was conducted at a trichology clinic in Bengaluru between October 2013 and April 2014 with a total of 37 cases of PHG and 37 age- and gender-matched controls.Materials and Methods:A total of 100 subjects were investigated for various parameters such as hemoglobin, serum ferritin, zinc, copper, calcium, Vitamin B12, and Vitamin D after obtaining informed consent.Statistical Analysis Used:Chi-square test was used to compare proportions between groups. Means were compared between groups using Student's t-test.Results:Serum ferritin levels were lower in patients with PHG as compared to the control group and the differences were statistically significant (P < 0.001). Furthermore, as compared to the controls, patients with PHG had lower serum Vitamin B12 levels (P < 0.001). Individuals with PHG had significantly lower levels of high-density lipoprotein cholesterol (HDL-C) as compared to the control group (P < 0.001). Significant proportions of patients with PHG had a sedentary lifestyle and admitted to having irregular eating habits.Conclusion:PHG is associated with low serum ferritin, Vitamin B12, and HDL-C levels in Indian patients aged <25 years. However, studies with large sample sizes may be required to conclusively define these putative associations.