Early-onset androgenetic alopecia (AGA) is a common, hereditary hair loss condition in men, often starting in the early twenties. It involves gradual thinning of hair, influenced by genetics, hormones, and other factors like smoking and family history. Early identification of these risks could support timely intervention. This case control study aimed to evaluate androgen levels, specifically the free androgen index(FAI) and dehydroepiandrosterone sulfate ( DHEA-S), in males with early-onset AGA versus healthy age and sex matched controls. It also determined risk factors contributing to premature AGA in Egyptian males. This study included 40 male patients between 18 and 30 years with early-onset AGA and 40 age-matched healthy male controls. Risk factors and hormonal profiles including sex hormone binding globulin (SHBG), total testosterone (TS), DHEA-S as well as calculated FAI were compared between both groups using ELISA kit. Our study found that early-onset AGA is linked to a strong family history, smoking, coffee intake, hair straightener use, fast-food diets, and recent weight gain. Early-onset AGA patients also showed statistically significant lower SHBG levels and higher TS, DHEAS and FAI compared to healthy controls. These findings suggest that early-onset AGA is shaped by a complex interaction of different factors, highlighting the importance of a comprehensive approach and advice to patients as regards different risk factors.