Objective To investigate the clinical effect of microneedle combined with minoxidil in the treatment of alopecia. Methods A total of 44 patients with alopecia admitted to our hospital from April to July 2022 were selected as the control group, and 44 patients with alopecia admitted to our hospital from August to December 2022 were selected as the study group. The control group was treated with minoxidil, and the study group was treated with microneedle combined with minoxidil. The clinical efficacy, hair density and diameter, and complications were compared between the two groups. Results The total effective rate of treatment in the study group (97.73%) was higher than that in the control group (86.36%), and the difference was statistically significant (P <0.05). The hair density and diameter of the two groups after treatment were greater than those before treatment, and those in the study group were greater than those in the control group, the difference was statistically significant (P <0.05). The incidence of complications in the study group (2.27%) was lower than that in the control group (13.64%), and the difference was statistically significant (P <0.05). Conclusion The clinical effect of microneedle combined with minoxidil in the treatment of alopecia is more accurate, which can increase the density and diameter of hair, and the incidence of complications is low.