This review outlines the findings associated with topical minoxidil use. Approximately one-third of the treated patients will obtain terminal hair growth using a 2 to 3% solution twice a day. Patients should receive treatment for a minimum of six months to evaluate the drug's efficacy. Factors associated with patients who obtained new hair growth include: a thinning versus absolute baldness, treatment initiated at a relatively younger age, and hair growth noted within three months. Following a positive growth response, there may be a reduction in new hair growth gained with minoxidil use for more than one year. Stopping the medication is associated with an exacerbation of hair loss. Currently, patients with hypertension, cardiovascular disease, or any serious systemic illness should be excluded from therapy. Patients should be monitored every four to six months, or sooner with any complaints. Initial evaluation should include monitoring of the blood pressure, pulse, electrocardiogram and serum lipid determinations.