An update of recent surgical techniques as applied to the nail unit is presented. The procedures discussed touch on areas of internal medicine, oncology, biomechanics, trauma, podiatry, infectious disease, and genodermatoses. It is evident in reviewing the literature that a mushrooming of interest in the nail unit is taking place and that this structure has inherent importance in that it may involve all facets of health care. I hope that the reader will emerge from this chapter with a greater respect for the nail and will be stimulated to learn more about it.