Background: Warts are cutaneous manifestations of human papillomavirus (HPV). Trauma and maceration facilitate initial epidermal inoculation, followed by autoinoculation. Immune factors influence spread. Zinc, an essential micronutrient, plays crucial immunological roles, activating lymphocytes and cytokines against viral penetration and replication. Zinc deficiency is linked to numerous skin disorders. High-dose oral zinc sulfate has shown therapeutic efficacy in recalcitrant and multiple warts. This study aimed to determine the association between serum zinc levels and multiple cutaneous warts. Materials and methods: A total of 110 patients with cutaneous warts and 110 matched controls were included. Clinical characteristics and serum zinc levels were recorded and analyzed. Results: Normal serum zinc levels (60–180 µg/dL) were found in 91 cases and 100 controls, while high levels were observed in 9 cases. Cases showed significantly higher mean serum zinc levels compared to controls (121.1 ± 35.78 µg/dL vs. 101.8 ± 20.48 µg/dL, P = 0.0001). Conclusion: Patients with multiple cutaneous warts exhibited higher mean serum zinc levels. No significant association was observed between zinc levels and wart duration or number. © 2024 Elsevier B.V., All rights reserved.