Vitiligo is characterized by depigmented patches resulting from loss of melanocytes. Vitiligo can be challenging to treat and exhibit an unpredictable clinical course. Phototherapy has emerged as a prominent treatment option for vitiligo, utilizing various light modalities (not only UV, but also visible light) to induce disease stability and repigmentation. Phototherapy is still considered as the “gold standard” treatment for vitiligo, despite the recent introduction of new drugs that target the underlying immune mechanisms involved in vitiligo pathogenesis. Narrowband ultra-violet B, (either conventional NB UVB, 311 nm, or excimer sources 308nm) remains the most commonly employed, studied, and effective phototherapy modality for vitiligo. Recent work has pointed out the possibility to use a new 311 solid state laser as an alternative to the 308 nm excimer laser. The presentation focuses on the clinical applications and molecular mechanisms of phototherapy in vitiligo. Special attention is given to reviewing different types of lamps, guidelines, and the utilization of targeted phototherapy modalities. Additionally, the integration of phototherapy with other treatment modalities, including its use with the new drugs (JAK inhibitors) in vitiligo, is discussed. The issues represented by photo-adaptation and the possible risk of carcinogenesis in human skin are also examined. Also, red-light and blue light therapy via LEDs can stimulate repigmentation in patients with vitiligo with minimal adverse events. Recently the use of heliotherapy has been reappraised when therapy with artificial UV is not available: exposure to natural sunlight can be monitored with a dedicated App in order to help the patients to select appropriate location and duration of exposure based on real time dosimetry. The review underscores the evolving landscape of phototherapy and offers insights into optimizing therapeutic outcomes and addressing the challenges ahead. Phototherapy is a valuable therapeutic option for managing vitiligo, with potential for further advancements.