Nail involvement is common in patients with psoriasis and psoriatic arthritis, affecting 80%-90% of patients at some time. It also has significant effects on quality of life. Psoriatic nail disease can be refractory to treatment, and different features may respond variably to different therapies. The lack of standardized outcome assessments hinders the interpretation of available data. In this systematic evidence-based review of the literature, we assess various treatments for psoriatic nail disease.