There is neither a cure for alopecia areata (AA) nor any universally proven therapy that induces and sustains remission in patients afflicted with this autoimmune disease. AA is characterized as a nonscarring alopecia which affects children and adults. It can be relatively easy to treat when the disease is patchy and limited; but when children and adults present with long standing extensive scalp and body hair loss, successful management can be challenging. Of the treatment choices available, physicians and midlevel providers usually select a cost-effective treatment approach based on disease duration, disease activity, age of the patient, and disease extent. In this manuscript, the clinical presentation, epidemiology, pathophysiology, plus current and evolving treatments for AA will be reviewed.