Subungual exostosis is a benign, osseocartilaginous nail tumor that may affect the distal phalanx of the fingers and toes, and may be associated with a t(X;6)(q24–26;q15–21) chromosomal translocation [1–5]. On histology, subungual exostosis is characterized by the presence of trabecular bone, typically surrounded by a fibrocartilaginous cap, and represents a separate clinical entity from osteochondroma, which is characterized by a hyaline cartilage cap [4, 6, 7]. Because subungual exostosis may present either with or without pain and with or without nail dystrophy, the differential diagnosis is broad and includes onychocryptosis, glomus tumor, amelanotic melanoma, traumatic onycholysis, onychogryphosis, pyogenic granuloma, and verruca [4, 8, 9].