Generalized vitiligo is an acquired disorder in which patches of depigmented skin, overlying hair and oral mucosa result from progressive autoimmune loss of melanocytes from the involved areas. Perhaps the most common pigmentary disorder, vitiligo results from a complex interaction of environmental, genetic and immunologic factors that ultimately contribute to melanocyte destruction, resulting in the characteristic depigmented lesions. In the past few years, studies of the genetic epidemiology of generalized vitiligo have led to the recognition that vitiligo is part of a broader, genetically determined, autoimmune and autoinflammatory diathesis. Attempts to identify genes involved in vitiligo susceptibility have involved gene expression studies, allelic association studies of candidate genes and genome-wide linkage analyses to discover new genes, and these studies have begun to shed light on the mechanisms of vitiligo pathogenesis. It is anticipated that the discovery of biological pathways of vitiligo pathogenesis will provide novel therapeutic and prophylactic targets for future approaches to the treatment and prevention of vitiligo and its associated autoimmune diseases.