Patients often fear nail surgery because of the pain associated with anesthesia and post-operative care. Potential dystrophic sequelae are of concern to the practitioner. A thorough knowledge of the techniques of anesthesia, nail anatomy, and surgical procedures is a prerequisite for successful nail surgery with almost no pain and minimal scarring. It also is mandatory to involve a dermatopathologist who is familiar with the histologic idiosyncrasies of the nail unit.