Background:Onychomycosis is a fungal infectionin the nail region that accounts for 18-40% of all nail problems. Traditionally KOH, culture or PASS is used for the diagnosis of onychomycosis. onychoscopy is a noninvasive technique that enables the visualisation of the nail plate as well as the nail folds, nail bed, nail matrix, and the vessels and fine structure of the free margin of nail. Objective: Present study aims to analyse onychoscopic patterns in clinically proven onychomycosis. Methodology: Out of 15 clinically suspected cases, 11 patients (150 nails) were with confirmed onychomycosis were studied by onychoscopy. Videodermatoscope was used in both polarized and non-polarized mode to study the various patterns in onychomycosis. The most frequent onychoscopic patterns were identified. Results:The mean duration of onset of disease was 11.67±7.63 years and mean duration of disease progression was 5.33±4.50 years. PSOM was observed in 50 nails, DLSOMfound in 50 nails, WSO reported in 30 nails and Endonyx found in 20 nails. Among 150 nails, special patterns of onychomycosis in patients revealed ruin appearance in 78 (52%) nails, longitudinal striae in 57 (38%) nails, and spike pattern 15 (10%) nails. Conclusion:According to the findings of our study, nail plate dermoscopy can be used as an easy, rapid, and affordable method to improve onychomycosis diagnostic accuracy in situations where mycological investigations are not easily accessible.