Introduction: Onychomycosis is a common encounter in skin clinics that has varied oral and topical medications for its treatment. At times, conventional oral regimens might be contraindicated and owing to slow growth rate of the nail, these can be time consuming and may show failure due to drug resistance. In this study we evaluate the role of a novel therapy, Nd:YAG LASER in its treatment. This study aimed at evaluation of the efficacy and safety of Nd:YAG LASER 1064-nm in the treatment of onychomycosis. Material and methods: A total of 58 onychomycotic nails (constituted by 30 patients) which were KOH mount positive for fungal elements were treated with weekly sessions of Nd:YAG LASER 1064-nm until clinical resolution or 12 weeks, whichever was earlier. Besides examination for clinical cure, KOH mount was also performed at each follow up, until mycological cure was obtained. Results: Out of 46 onychomycotic nails that completed the study, 82% showed mycological cure and 78% showed clinical cure at 6 months. Seven patients were lost to follow up over the period of 6 months. Mycological cure was found to be attained earlier than clinical cure. No adverse effects were observed in the majority except for burning sensation and mild erythema over the nail folds in 2 patients (4%). Conclusion: Based upon the results of our study, Nd:YAG LASER 1064-nm laser is an effective and safe modality in the treatment of onychomycosis and can be used both as an alternative to conventional regimens as well as first line therapy in near future.