Removal of the nail matrix is indicated in a variety of recalcitrant conditions in which the growth of the nail plate causes mechanical problems such as recurrent onychocryptosis or pain due to pinching or pressure. Before performing a matricectomy, the physician must consider the use of nonsurgical methods and the possible contraindications to surgery. Once the decision for matricectomy is made, the physician should then utilize the modality with the least morbidity and greatest convenience for the patient. A wide repertoire of methods of matricectomy is available for use; all methods, when performed properly, have similar high rates of cure.