Objective To investigate the clinical efficacy and safety of 1% cetirizine hydrochloride drops in the treatment of male androgenetic alopecia. Methods A total of 64 male patients with androgenetic alopecia who were treated in Jinan City Hospital for Skin Disease Prevention and Treatment from September 2022 to August 2023 were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 32 patients in each group. The control group was treated with 5% minoxidil liniment, and the observation group was treated with 1% cetirizine hydrochloride drops. The clinical efficacy, visual subjective score, total hair density and adverse reactions were compared between the two groups. Results The total effective rate of the observation group after treatment was 81.25%, which was slightly lower than 90.63% of the control group, but the difference was not statistically significant (P >0.05). The total hair density of the two groups after 3 and 6 months of treatment was higher than that before treatment, but the total hair density of the observation group after 3and 6 months of treatment was lower than that of the control group (P <0.05). There was no statistically significant difference in the visual subjective scores of the two groups when comparing them 3 months of medication (P >0.05). The visual subjective score of the observation group was lower than that of the control group after 6 months of medication (P <0.05). There were no obvious and serious adverse reactions in the two groups after treatment. Conclusion 1% cetirizine hydrochloride drops is effective in the treatment of male androgenetic alopecia, which can increase the total hair density and the visual effect of scalp hair. It is a new choice for the treatment of AGA and has good safety.