Vitiligo is a chronic acquired depigmenting dermatosis caused by selective destruction of melanocytes. Its pathogenesis is complicated and related to autoimmune abnormalities and genetic susceptibility. Conventional therapies such as glucocorticoids and phototherapy have limited efficacy, especially for patients with refractory or progressive lesions, accompanied by high recurrence rates. There is an urgent clinical demand for therapeutic agents with stronger targeting property and higher safety. Existing studies have demonstrated that the Janus kinase (JAK)/signal transducers and activators of transcription (STAT) signaling pathway participates in the onset and progression of vitiligo. JAK inhibitors block JAK/STAT signal transduction, suppress the production of pro-inflammatory cytokines, restore melanocyte function, and achieve repigmentation of skin lesions. As a JAK1/2 inhibitor, ruxolitinib cream exhibits repigmentation effect with favorable safety, and it can produce synergistic benefits when combined with phototherapy, microneedling and other modalities. Nevertheless, systematic reviews concerning the mechanism, clinical efficacy, safety and combination regimens of ruxolitinib remain insufficient. It is necessary to summarize relevant evidence to guide individualized clinical management. This paper reviews the mechanism of action, clinical efficacy, safety and combination therapeutic strategies of ruxolitinib cream in individualized treatment for vitiligo, so as to provide references for optimizing current clinical treatment protocols.