Background: Acne is generally regarded as a skin disorder of adolescents, but off late the prevalence has been increasing in adults too; especially in women. Hyperandrogenism is considered as an important contributing factor for the development of acne in adult women. If elevated androgens are found patients may benefit from various methods of hormonal therapy and reduce psychological morbidity. As there is paucity of data on role of circulating androgens in female acne, this study was undertaken to evaluate the same. Aims and objectives: To evaluate the correlation between serum free testosterone levels and adult acne in females. Materials and methods: A case control study from January 2020 to June 2021 was conducted at Department of DVL, Guntur Medical College. 50 adult acne female patients and 50 age and sex-matched healthy controls were enrolled in the study. Blood levels of free testosterone, total testosterone, sex hormone binding globulin were measured on day 1-3 of menstrual cycle and free androgen index was calculated. Results: Adult acne cases were commonly reported in 25-30years age group with moderate severity. Although free testosterone levels were within normal limits in cases statistically significant difference was seen compared to the controls. Total testosterone and free androgen index vales were significantly elevated in cases and correlated positively with severity of acne. Conclusion: Free androgen index can be used as a surrogate marker for hyperandrogenemia in cases where free and total testosterone cases fall within normal limits. We reiterate the role of androgens and as a corollary the need for hormonal evaluation and timely anti- androgen therapy for adult acne in females.