Diagnostic, monitoring, response, predictive, risk and prognostic biomarkers of disease are all widely studied, for the most part in biological fluids or tissues, but with steadily growing interest in alternative matrices of which nails are an example. Here we comprehensively review studies dealing with molecular or elemental biomarkers of disease, as opposed to semiological, pharmacological, toxicological or biomonitoring studies.Nails have a long history of use in medicine as indicators of pathological processes, and have also been used extensively as a matrix for monitoring exposure to environmental pollution.Nail clippings are simple to collect non-invasively, to transport and to store, and the matrix itself is relatively stable. Nails incorporate, and are influenced by, circulating molecules and elements over their several months' of growth, and it is widely held that markers of biological processes thus included will remain in the nail, even when their levels in blood have declined.They thus offer the possibility, not only of looking back into a subject's metabolic history, but also of studying biomarkers of processes that operate over a longer time scale such as the posttransational modification of proteins.Reports on ungual biomarkers of metabolic and endocrine diseases, cancer, and psychological and neurological disorders will be presented, and an overview of the sampling and analytical techniques provided.