A retrospective review has been carried out on 200 randomly selected patients with ingrowing toenail in order to assess the surgical management and its results. There was a predominance of males between the ages of 11 and 30 with an ingrowing toenail. Despite the high recurrence rate following simple avulsion of the toenail, its place in the initial management of the condition is justified. As regards more definitive surgery, total proximal nail bed ablation was found to give the best results. Sepsis at the time of operation neither increased the recurrence rate nor caused severe postoperative sepsis. A surgical management policy for the treatment of ingrowing toenail is outlined and discussed.