The invasion of human toenails by microorganisms is not always understood. Efficacious treatment, however, depends on establishing proper identification and understanding the improper diagnosis results in failed treatment. Most medical treatment presently is directed toward several fungal species. This article identifies these organisms by means of diagrams and transmission and scanning electron microscopy. The article also discusses microorganisms that are unresponsive to dermatophytic treatment and discusses how aspergillus, saprophytes, and yeasts can affect nails and mimic dermatophytic infections.