pemphigus vulgaris is a life threatening relapsing disease, the first line in its treatment is systemic steroids, and due to the high rate of side effects caused by systemic steroids in pemphigus vulgaris patients, some immunosuppressant drugs have been introduced as an adjuvant steroid sparing agents, and one of these immunosuppressants is methotrexate, and in spite of the lack of its use in pemphigus vulgaris, a few studies have shown an encouraging results of its use, and have advised to carry out more studies about it as an immunosuppressant which has been omitted from usage in pemphigus vulgaris for a long time.