Aim: The aim of this study was to compare the efficacy of three topical retinoids (adapalene, tretinoin, and tazarotene) in treating mild to moderate acne vulgaris, focusing on lesion reduction, acne severity, patient satisfaction, and tolerability over a 12-week period. Materials and Methods: A randomized, controlled, double-blind trial was conducted involving 150 participants aged 18-35 years, diagnosed with mild to moderate acne vulgaris. Participants were divided into three groups (50 per group): Group A (Adapalene 0.1% gel), Group B (Tretinoin 0.025% cream), and Group C (Tazarotene 0.1% gel). Each treatment was applied once daily for 12 weeks. Primary outcomes included reduction in total acne lesion count, while secondary outcomes included improvement in Global Acne Grading System (GAGS) scores, patient satisfaction, and tolerability. Data were collected at baseline, week 4, week 8, and week 12. Results: By week 12, all groups showed a significant reduction in total lesion count: Group A (8.5), Group B (7.9), and Group C (8.3). GAGS scores improved significantly across all groups, with no significant differences between treatments. The most common side effects were erythema, dryness, and peeling, with Group C (Tazarotene) showing a slightly higher incidence of adverse effects (40% dryness, 30% irritation). However, these differences were not statistically significant. Patient satisfaction was highest in Group A (8.4), followed by Group B (8.1), and Group C (7.9). Tolerability scores were also highest in Group A (8.6). Conclusion: All three topical retinoids effectively reduced acne lesions and severity without significant differences in efficacy. Adapalene demonstrated better tolerability and slightly higher patient satisfaction, making it a preferred option for those with sensitive skin. Treatment choice should consider patient-specific factors such as skin type and side effect profiles.