Aim: The aim of this study was to compare the effectiveness of Narrowband UVB (NB-UVB) therapy and Psoralen plus Ultraviolet A (PUVA) therapy in treating patients with generalized vitiligo over a 3 months period. Materials and Methods: This randomized, controlled, comparative study involved 100 patients diagnosed with generalized vitiligo, equally divided into two groups. Group A (n = 50) received NB-UVB therapy three times a week, while Group B (n = 50) received PUVA therapy twice a week. Patients were included if they were between 18-50 years of age, had more than 10% of their body surface area affected by vitiligo, and had not undergone prior phototherapy within the last six months. The primary outcome was the percentage of repigmentation in the treated areas, assessed at baseline, one month, and three months. Secondary outcomes included patient-reported satisfaction and adverse effects such as erythema, pruritus, and blistering. Results: At baseline, both groups had comparable demographic characteristics, including age, gender, and extent of vitiligo (p > 0.05). After one month, the majority of patients in both groups had less than 25% repigmentation, with 56% in Group A and 60% in Group B. By three months, more significant repigmentation was observed, with 36% of patients in Group A achieving 51-75% repigmentation, compared to 30% in Group B. Additionally, 20% of Group A and 26% of Group B achieved over 75% repigmentation. Although PUVA showed slightly higher rates of greater repigmentation, the differences were not statistically significant (p > 0.05). Adverse effects were more frequent in Group B, with erythema reported in 28% of PUVA patients compared to 20% in NB-UVB patients, but these differences were not significant. Patient satisfaction scores were similar between the groups, with Group A scoring 8.5 and Group B scoring 8.3 (p > 0.05). Conclusion: Both Narrowband UVB (NB-UVB) and PUVA therapies were effective in promoting repigmentation in vitiligo patients, with no statistically significant differences in overall outcomes. NB-UVB had a slight advantage in tolerability, while PUVA therapy resulted in marginally higher repigmentation rates. Both therapies were well-received by patients, and the choice between them should be individualized based on patient preferences and side effect profiles.