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Sulfasalazine is an aminosalicylate primarily used in the treatment of rheumatoid arthritis and ulcerative colitis. Its immunomodulatory, anti-inflammatory, and antiproliferative properties make it a potential therapeutic option for various dermatological disorders. Owing to its wide range of effects, it is often used off-label in dermatological diseases, such as alopecia areata, psoriasis and psoriatic arthritis, lichen planus, and pemphigus. However, the level of evidence supporting its efficacy and safety in dermatology is limited. More research is needed to uncover the full potential of sulfasalazine in dermatology. The present article is a detailed review of the pharmacology, modes of action, side effects, and contraindications of sulfasalazine, along with an up-to-date review of the evidence underlying its use in various dermatological conditions.