BACKGROUNDTreatment of ingrown toenail includes various nonsurgical and surgical treatments. However, there is no consensus on the ideal first-choice treatment.OBJECTIVETo compare phenolization versus surgical matricectomy (SM) after lateral nail plate avulsion in terms of efficacy, recurrence rates, postoperative outcomes, and cosmesis.METHODSThe authors enrolled 45 consenting patients and randomized them into 2 groups (Group 1 = phenolization and Group 2 = SM) using stratified block randomization and followed them up at 1 week, 1 month, and 6 months.RESULTSThe median percentage improvement in pain visual analog scale (VAS) score was comparable between the 2 groups (p = 0.793). The mean photo VAS showed significant improvement in Group 1 at 1 week (p = 0.00) and 1 month (p = 0.02) but not at 6 months (p = 0.44). The median number of days for pain relief (p = 0.169), for healing (p = 0.192), and for resuming work (p = 0.136) were not significantly different between the 2 groups. The time required to regain normal morphology was significantly longer in Group 2 (p = 0.006). None of the patients in either group presented with recurrence at 6 months and 1 year. The authors observed failure of treatment in 1 patient in Group 2.CONCLUSIONBoth procedures were equally efficacious, had minimal complications, and showed no recurrence at 6 months and 1 year.