Follicular unit extraction (FUE) is a method of producing follicular unit hair grafts that involves removing the grafts individually from the scalp. The advantages of this technique over the conventional strip harvest are that it does not leave a linear scar, and the procedure produces little or no postoperative pain and discomfort. There are some disadvantages such as increased surgical times, graft fragility, and higher cost to the patient. This article describes the instrumentation and surgical methodology of FUE. It also presents some surgical difficulties and how to minimize their impact. Indications and patient candidacy are also discussed.