Background Androgenetic alopecia (AGA) is the result of progressive patterned hair density reduction and sometimes can be associated with telogen effluvium (TE). The efficacy of conventional therapy is variable, and therefore, there is a need for adjuvant and newer modalities of treatment in order to give faster and better outcomes. Microneedling has been reported to be a promising, effective, and safe new technique in the treatment of AGA. Objective The aim of this study was to prove that microneedling procedure should be offered to patients with AGA and TE along with the existing therapeutic modalities, in order to obtain faster hair regrowth and, therefore, a better patient compliance. Patients and methods We collected data of 36 females, 29 with AGA, and 7 with TE, and 14 males with AGA between January 2017 and December 2018 and then treated with 3 session of microneedling over a total period of 6 months. Results No serious adverse side effects were reported. All the patients reported a partial or complete reduction in hair loss, associated to the perception of improvement of hair density and thickening of the hair shaft diameter, results confirmed by clinical iconography and trichoscopy. Conclusions Scalp areas typical affected by AGA, that is, the vertex in males and the frontal area in females, are the ones that showed the greater percentage of improvement. Moreover, microneedling can have a role also in TE, especially when cosmetic procedures do not give enough results, because it induces a rapid arresting of the hair loss.