Organizational chirality on surfaces has been of interest in chemistry and materials science due to its scientific importance as well as its potential applications. Current methods for producing organizational chiral structures on surfaces are primarily based upon the self-assembly of molecules. While powerful, the chiral structures are restricted to those dictated by surface reaction thermodynamics. This work introduces a method to create organizational chirality by design with nanometer precision. Using atomic force microscopy-based nanolithography, in conjunction with chosen surface chemistry, various chiral structures are produced with nanometer precision, from simple spirals and arrays of nanofeatures to complex and hierarchical chiral structures. The size, geometry, and organizational chirality is achieved in deterministic fashion, with high fidelity to the designs. The concept and methodology reported here provide researchers a new and generic means to carry out organizational chiral chemistry, with the intrinsic advantages of chiral structures by design. The results open new and promising applications including enantioselective catalysis, separation, and crystallization, as well as optical devices requiring specific polarized radiation and fabrication and recognition of chiral nanomaterials.