BACKGROUND Background: Premature greying of hair (PGH) is a clinical entity which has multiple ramifications such as low self- esteem, inferiority complex and may interfere with an individual’s social interaction capabilities and hence adversely affect the individual’s psychosocial health. As there is paucity of epidemiological, investigative and psychoanalytical studies on PGH from the Indian subcontinent, the present study has been undertaken to ascertain role of biochemical factors and assess knowledge, attitude, practice in patients of premature greying of hair, so as to explore the possible association of this entity with common systemic disorders and deficiencies which may possibly be related to its etiology and study comprehensively in detail the impact of quality of life in these patients of PGH by using a detailed KAP questionnaire. OBJECTIVE Objective: To study the biochemical factors and knowledge, attitude, practice in patients of premature greying of hair. METHODS Materials and methods: A case control study including 75 cases and equal number of age and sex matched controls was conducted in a tertiary care hospital. Various epidemiological variables and biochemical parameters (Vit B12, Vit D, Calcium, Iron profile, lipid profile, thyroid hormones) were ascertained and these were compared between the cases and controls. Severity of greying was assessed using Greying severity score (GSS) and a knowledge, attitude, practice study was conducted by administering a pre validated questionnaire to assess impact on quality of life of these affected individuals. RESULTS Results : Significant differences between cases and controls in the serum levels of biochemical parameters namely Vit B12 (P =.001), Vit D (P = .004), serum iron (P <.001), ferritin (P <.001) & TIBC(P = .037), and thyroid hormones T4 (P =.002) & TSH (P= .041) was found. No correlation between PGH and serum calcium & lipid profile was derived. Along with this, statistically significant difference was noted in the appetite pattern of cases and controls (P =.003). Stress, smoking, altered sleep pattern and bowel habits were also more prevalent in cases as compared to controls. It was also noted that majority study cases belonged to lower middle class of the modified Kuppuswamy scale. Through KAP study, which was extremely comprehensive and detailed in nature, it was observed that PGH has a significant affect on quality of life of these patients. CONCLUSIONS Conclusion: The study reveals a strong association between PGH and deficiency of Vit D, abnormal levels of Vit B12, hypothyroidism and deranged iron profile; and altered appetite patterns. Along with this prevalence of stress, smoking, altered sleep pattern and bowel habits was also higher in PGH cases. Hence, all these parameters should be analysed in such patients. KAP analysis was a unique approach to study common conceptions and practices in PGH cases and it’s psychological impact.