Background: Alopecia areata (AA) is a common disease with an unknown etiology. It is a chronic disease with causes severe disfigurement. So it may significantly affect the patients’ quality of life (QOL). This study was designed to evaluate illness perception and QOL in patients with AA. Patients and Methods: A questionnaire consisting of 28 questions about causes, course and the impact on QOL were given to patients with AA older than 12 years attending a private skin clinic in 1999 in Tehran. The questions were asked as closed questions and the patients answered them anonymously as “I agree”, “I do not know” and “I disagree”. Only questionnaires with more than 80% of questions answered were analyzed. The role of age, sex, duration, previous treatment, education, severity and family history of AA were assessed. Results: 80 patients (42 male and 38 female) with a mean age of 27.5±9.3 years and disease duration of 7.8±7.7 years entered the study. 60 of them had AA and 20 had alopecia totalis/universalis (AT/AU). 77% of patients believed on the role of stress as the cause of disease, more in older patients and shorter duration. 17% believed on the role of genetic background, more in patients with positive family history of AA or longer duration of disease. AA had a pronounced effect on QOL of 58% of patients, more in younger patients. 51% of patients considered their disease as severe, more in younger patients or severe disease. Only 58% of patients considered their treatments effective and 49% of them believed it will improve with praying. Conclusion: AA may considerably affect various aspects of patients’ lives. The knowledge of patients about the causes and course of this disease is very limited. Physicians should spend more time on the education of patients.