Nail psoriasis presents a disfiguring and recalcitrant condition with varied clinical presentations. Various modalities are available such as systemic therapies like methotrexate, cyclosporine, biologicals and topical therapies in form of ultra potent topical steroids, topical retinoids etc are available.Systemic therapies such as methotrexate have yielded significant results in management of nail psoriasis along with resolution of cutaneous lesions. These are fraught with systemic side effects and often take longer duration to achieve significant improvement in nail lesions. Intramatricial therapies in form of triamcinolone acetonide,methotrexate, cyclosporine have been tried. Hence targeted therapies with minimal side effects are needed especially in patients with limited cutaneous lesions and mainly nail involvement. Method: We conducted a study in our institute where intramatricial methotrexate was used in doses of 5 mg and 2.5 mg. 40 patients were selected from the outpatient department of GGSMCH FARIDKOT. They were divided into 2 groups randomly using envelope method.Prior to injecting methotrexate, a distal ring block was given to minimise the pain. Baseline investigations were done before initiation of therapy and then 1 week after first injection was given.Injections were administered at base line followed by second dose at 1 week after the first and 3rd at 2 weeks after the first. NAPSI was recorded at each visit, with photographs as clinical evidence and then at 6 weeks and 12 weeks. Datawas entered in MS Excel and analysedusing SPSS 17.0 version.Patients were followed up at 6 months and 12 months, to observe any recurrence or determine the clinical improvement after cessation of therapy. Results: Reduction in mean NAPSI was observed in both groups with very few side effects.Difference in results between 2 groups were statistically insignificant, though the group in which 5mg of methotrexate was used showed faster onset of results. Both the doses showed similar results. Side effects were minimal apart from injection site pain. Further studies with other modalities and using different doses of methotrexate are needed to determine appropriate dosages with minimal side effects and to compare its effectiveness and safety with other modalities. Intramatricial methotrexate at low doses presents a novel approach towards managing nail psoriasis.