Objective To summarize the effectiveness of modified surgical repair for severe ingrown toenail. Methods Between January 2005 and December 2010, 13 patients with severe ingrown toenail (16 toes) were treated. There were 12 males (15 toes) and 1 female (1 toe), aged 18-32 years with an average of 20 years. The disease duration was 1-15 years (mean, 2 years and 9 months). All affected toes were great toes. Ingrown toenail occurred bilaterally in 3 cases and unilaterally in 10 cases. Granulation tissue surrounding nail-edge, embedded toenail, and necrotic nail bed were completely removed; tension glue was used to make wound edge close to nail bed. Results At 3-5 days after operation, wound congestion, swelling, and exudation were improved; at 7 days, new nail bed formed; at 2 weeks, all wounds healed, and nail bed was epitheliogenic, wound edge healed well close to nail plate, and patients returned to normal life. At 6 months after nail extraction, new toenail grew and nail groove formed. No recurrent sign was found during 24-month follow-up. Conclusion Modified surgical repair is one of effective methods to treat severe ingrown toenail with the advantages of good appearance and low recurrent rate.