Onychomatricomas (OM) are rare subungual tumors first described just over a decade ago. Surprisingly, these lesions still rarely are reported in the literature. This may be because of a lack of awareness, understanding, or interest in these perceivably benign lesions. In this review, we discuss the current literature and understanding of OM. We attempt to ascertain predilections and patterns in an attempt to establish a stronger appreciation of OM, and to encourage future reports. We emphasize the importance of reporting such lesions; with a larger literature base, prevalence, etiology, and pathogenesis can be better determined.