Sulfasalazine can be a valuable alternative treatment option in AA patients who are resistant to other therapeutic modalities. It acts through immunomodulatory and anti-inflammatory effects. Sulfasalazine may be prescribed as monotherapy or combined with other therapies especially corticosteroid. Approximately one quarter of AA patients treated with sulfasalazine will achieve good to excellent response. Serious adverse reactions from sulfasalazine even in longterm use or when combined with other treatments are rare. However, a close clinical and laboratory monitoring is recommended especially at the initial period of treatment.