Background:This prospective study aimed to evaluate the efficacy and safety of Dexamethasone Methotrexate Pulse therapy in treating autoimmune bullous diseases, specifically Pemphigus Foliaceus, Pemphigus Vulgaris, and Bullous Pemphigoid.Methods:Eighteen patients were enrolled and treated at the Dermatology Department, Coimbatore Medical College and Hospital, undergoing monthly assessments, individualized medication, and close monitoring. Sociodemographic factors, clinical types, treatment responses, and complications were systematically analyzed.Result:Pemphigus Vulgaris emerged as the predominant clinical type (55%), with 67% of participants exhibiting severe disease. Remission rates varied; Pemphigus Foliaceus achieved 100% remission within 6 months, while Pemphigus Vulgaris showed rates of 30% within 6 months and 80% within 9 months. Bullous Pemphigoid demonstrated robust responses, with 100% achieving remission within 9 months. Immediate complications affected 11% of participants, including palpitations and diarrhea, while delayed complications were observed in 53%, encompassing weakness, infections, and weight gain.Conclusion:Dexamethasone Methotrexate Pulse therapy demonstrated varying efficacy across autoimmune bullous diseases. Notably, Pemphigus Vulgaris and Bullous Pemphigoid showed favorable responses. Immediate and delayed complications underline the need for vigilant management.