Background: Psoriasis treatment is very important regard to mental sequeler and creating morbidity. First line treatment of generalized plaque type psoriasis includes methotrexate, phototherapy and retinoids. Objective: To compare bath-PUVA and acitretin in the treatment of generalized plaque type psoriasis. Patients and Methods: 40 patients with generalized plaque type psoriasis with PASI scores of 15-20 in Razi Hospital in Tehran were randomly divided into 2 groups after giving consent. Each group included 20 patients. The first group was treated three times a week with bath-PUVA and the second group was treated with acitretin 0.7 mg/kg/day. The efficacy of 2 treatment regimens were determined and compared using PASI scores. Results: The clearance rate was 65% in bath-PUVA group and 75% in acitretin group. Patients in bath-PUVA needed 29 sessions and accumulative dose of 105.46 J/cm² for clearance. Conclusion: Psoriasis patients responded to bath-PUVA treatment but this response required more sessions and higher total dose. The inherent differences and distinctive responses to light in the patients under study (In Iran) compared with patients with skin phototypes I, II might explain these differences.