Nail cosmetics are being used world over for nail enhancement, and their list is an ever expanding one. However, due to their widespread usage, there are an increasing number of adverse effects also being reported. These have been reported both in the users as well as service providers (nail salon workers/technicians). Adverse effects to nail cosmetics usually present to dermatologists, who need to be equipped to suspect, diagnose, and manage them. A whole range of newer nail cosmetic products are available now, which can lead to a variety of adverse reactions. These may be early and hence easy to temporally correlate with cosmetic usage; or have a delayed onset making it difficult to correlate with the nail cosmetic used. Varying presentations include onycholysis, infections, allergic dermatitis, psoriasiform nail changes, and systemic adverse effects. The range of clinical manifestations, prevention, and management of nail cosmetic-related adverse effects are detailed in this review.