Introduction Male androgenetic alopecia (AGA) is the most common type of hair loss in men. It accounts for more than 90% of all cases of alopecia in men . It occurs when genetically predisposed men are exposed to androgens. AGA may negatively affect patient’s quality of life and can lead to social and job-related problems . AGA can also cause indirect physical harm, such as sunburn as a result of hair loss and exposure to ultraviolet light . AGA may also be associated with increased incidence of hypertension, hypercholesterolemia, and myocardial infarction . The only FDA approved therapies for treatment are limited to topical minoxidil and oral FIN with limited efficacy (40-60%) . As multiple factors are implicated in the pathogenesis of AGA and the existing conventional therapies (i.e. FIN and minoxidil) fail to target all of them; the demand for new treatment techniques for AGA is growing . Dutasteride (DST) is a dual 5?reductase inhibitor, with some reports about the use of oral DST in the treatment of AGA in men . Hesitancy about the widespread use of oral DST in the treatment of male AGA results from its potential side effects on erectile, ejaculatory functions and fertility . Mesotherapy using DST has been used in patients with AGA with promising results (8, . It is believed that systemic absorption after mesotherapy is equal to after oral DST because the scalp is highly vascular. So the possibility of using DST topically with scalp MN would have some advantages . Microneedling (MN) is a relatively new minimally invasive procedure involving superficial and controlled puncturing of the skin by rolling with miniature fine needles . The use of MN in combination with minoxidil showed promising results in treatment of AGA . Furthermore; the addition of MN to minoxidil and oral FIN improved AGA in patients who were resistant to minoxidil and oral FIN . To the best of our knowledge; the use of MN in combination with DST hasn`t been previously reported. This study was designed to evaluate the efficacy and safety of topical DST with MN in treatment of male AGA. Patients and methods This prospective, randomized, clinical study was approved by Ethical and Research committees at Faculty of Medicine, Sohag University. An informed written consent was obtained from all participants. The study included 30 male patients complaining of progressive hair loss diagnosed as AGA attending at Dermatology outpatient clinics at Sohag University Hospitals, Faculty of Medicine, Sohag University. Exclusion criteria ? Patients with other forms of alopecia including telogen effluvium, alopecia areata. ? Patients with dermatological or systemic illness known to cause diffuse hair loss (as thyroid disorders or anemia).