Management of simple nail bed lacerations and subungual hematomas has remained somewhat controversial. This article presents a 30-year-old case admitted to emergency department (ED) due to subungual hematoma with tuft fracture. The nail was partially loose, and the nail bed seemed more or the less intact. Rest of hand examination was normal. Plain radiographs showed fracture of the distal phalanx. Decision was made not to remove the nail bed and only to release the pressure by trephine technique under sterile condition. The patient was scheduled for ED follow up appointment after one week.