Background: Alopecia areata (AA) is an autoimmune disorder characterized by patchy, reversible hair loss. Increasing evidence suggests that immune dysregulation and hormonal imbalance may play a role in disease onset and progression. Objective: This study aimed to investigate the relationship between luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in patients with alopecia areata compared with healthy controls, and to assess their potential role in disease pathogenesis. Methods: A case–control study was conducted on 72 participants (42 patients with AA and 30 healthy volunteers) attending the dermatology outpatient clinic at Al-Ramadi Hospital, Al-Anbar, Iraq, between December 2019 and March 2020. Detailed clinical history and dermatological examination were obtained. Venous blood samples (5 mL) were collected, and serum LH and FSH levels were measured using standard laboratory techniques. Data were analyzed for age and gender distribution, and statistical significance was determined at p < 0.05. Results: Patients with AA demonstrated significantly higher LH and FSH concentrations compared with controls. LH levels were elevated across all age groups (mean 6.97 IU/mL vs. 4.62 IU/mL, p < 0.001). Similarly, FSH levels were higher in patients (mean 7.96 IU/mL) than controls (mean 4.93 IU/mL, p < 0.05). Gender analysis revealed significantly higher LH and FSH in both males and females with AA compared to controls. Conclusion: This study highlights a strong correlation between alopecia areata and elevated pituitary gonadotropins (LH and FSH). Screening for hormonal abnormalities in AA patients may provide insights into disease mechanisms and guide early therapeutic strategies, particularly in relation to immune-endocrine interactions.