Alopecia areata (AA) is a common and distressing condition in populations worldwide. The course of this condition is unpredictable and remains elusive. Patients with AA have a negative appraisal of their self-image, resulting in a demand for any effective treatment options. Hair transplantation might be considered for those patients who have exhausted standard clinical therapies for a period of time. However, the appropriate time to do hair transplantation in recalcitrant alopecia areata is still in question, or may be never.