Melasma is a common acquired circumscribed hyper-pigmentary disorder involving sun-exposed areas, particularly face. The high frequency of recurrence renders the management more challenging. Autologous platelet rich plasma (PRP) has promising potential in the treatment of melasma. This study evaluates the efficacy of combination of autologous PRP and Hydroquinone and compares it with the gold standard molecule 4% Hydroquinone. Thirty patients with melasma were enrolled in this split-face study conducted between 2018 and 2020. All the patients were prescribed Hydroquinone cream 4% to be applied on the affected area at night. Microneedling was performed once a month (total four sessions) on both sides of face, followed by application of autologous platelet rich plasma on right side and normal saline as control on left side of affected area. Modified Melasma Area and Severity Index (MASI) score, Patient satisfaction score and Physician's Global Assessment score were calculated at baseline and after each session and improvement was assessed. Improvement in mean modified MASI score was significant on both sides of face. Mean percentage improvement in modified MASI score on study side and control side was 82% and 69% respectively. The difference between the two sides was statistically significant in terms of modified MASI, patient satisfaction and physician global assessment scores. Adverse effects were mild and transient. Autologous platelet rich plasma is an effective and safe therapy for treatment of melasma. Combination of autologous PRP and 4% Hydroquinone showed greater improvement than hydroquinone alone.