This chapter describes some practical tips and pearls which can be used in improving the outcome of surgical treatment in vitiligo. The most common methods used in the surgical treatment of vitiligo include: punch grafting, suction blister grafting, autologous melanocyte-keratinocyte suspension transfer. Cultured melanocyte transplantation, though effective, is limited by the need for extensive laboratory support and a tedious process. Surgical management of vitiligo has been a remarkable breakthrough and innovations have been happening in all the procedures undertaken. There are scopes for further research and improvisations at various levels of the procedures. Suction blister epidermal graft, recipient site preparation, epidermal cell suspension, needling or microneedling, hair follicle transplant and chalazion clamp revisited are also described in this chapter.