A hamartoma is a benign, focal malformation resembling a neoplasm in its tissue of origin. This malady has not been reported to be manifested in the nail plate. Here, we describe a rare case of hamartoma under the nail plate of the first toe and its successful excision from a 30-year-old woman. We used palpation, radiologic analyses, excisional surgery, and histopathology to determine the presence of a hamartoma under the nail plate of the first toe. Removal of the mass was successful for the patient, and histopathologic analysis revealed characteristics of hamartoma. The presence of a hamartoma under the nail plate of the first toe is a unique finding that should be made aware to the clinical community.