Nail psoriasis is common in psoriatic patients, particularly in patients with joint involvement. It has a significant impact on their quality of life, affecting physical activities as well as causing emotional and social impairement. The disease is often refractory to treatment, and available therapeutic agents affect the matrix or the nail-bed features with variable success. The recent design of the Nail Psoriasis Severity Index allows a more standarized approach regarding outcome assessment. In this review, we assess treatment options of nail psoriasis and empahsize the importance of selecting modalities according to the particular psoriatic nail features.