The effectiveness of two methods of presurgical hand preparation, the 10 minute routine scrub and the 90 second Hydroscrub, in reducing microbial numbers under the fingernails was determined. Bacteriologic cultures of 162 subungual areas of nine subjects revealed prescrub microbial counts of up to 1.9 X 10(5) colony-forming units per area. After the surgical scrub, bacterial concentrations were reduced to a different degree among the persons tested. The mean values of 3.0 X 10(3) to 7.8 X 10(3) colony-forming units immediately after scrub indicated that neither of the two methods tested reduced the microbial population under the fingernails of most persons to acceptable levels. The finding of high postscrub microbial counts under the fingernails is of particular interest and significance in view of the relatively low counts on the fingertips. On the basis of the results of this study, we conclude that degerming of the areas under the fingernails by present methods is not satisfactory. The implication of these findings is discussed.