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The nail functions by protecting the digits and contributing to tactile sensation. Understanding nail anatomy is not only essential for understanding physiology but also comprehending the pathophysiology behind many nail presentations. Clinically, many cutaneous and systemic diseases can manifest on the nails. While a thorough history and physical can often correlate nail findings with their etiology, a biopsy may be necessary to reach a final diagnosis. Understanding the anatomy is important when obtaining tissue samples since an injury to the vital blood vessels and nerves supplying the nail can cause complications. This article aims to review all significant aspects of nail anatomy and address the clinical considerations above.