Vitiligo is an acquired circumscribed hypomelanosis with a worldwide incidence of 1-2%, with no gender predilection. Acral lesions of vitiligo are typically resistant to conventional treatments, leading to a significant reduction in affected individuals' quality of life. The objective of the study is to evaluate the efficacy of combined tacrolimus and 308 nm excimer laser therapy in treating acral vitiligo lesions. Results indicate repigmentation observed in all patients (100%), with a rate exceeding 75% in 8 out of 10 patients, particularly in those with isolated acral involvement evolving for less than 6 months. Adverse events are limited, with good tolerance. The combined treatment demonstrates statistically significant efficacy, achieving a repigmentation rate of at least 75%. Previous studies suggest tacrolimus alone may induce repigmentation, but comparative studies are needed to confirm these findings. Photodynamic therapies may offer improved outcomes by combining treatments, such as using topical tacrolimus with the 308 nm excimer laser, potentially accelerating repigmentation with sustained results.