An improved approach to subungual hematoma evacuation has been presented. Hand-held cautery is a cost-effective, precise method of treatment of subungual hematoma. Its use decreases the likelihood of unnecessary delay in the regrowth of the nail plate and secondary dystrophy that might result from pressure on the matrix caused by accumulated blood under the nail. The high temperature and fine tip make the cautery an excellent instrument to precisely and painlessly burn a small hole in the nail plate, allowing for evacuation of subungual hematoma.