A subxiphoid nevus, which is a pigmented nevus located on the nail bed (in common parlance, on the location of the finger (toe) nail), is a benign tumor of the skin most commonly composed of normal pigment-containing nevus cells and occasionally seen on the surface of the mucous membranes. There are various types of clinical manifestations. Most of them are dark brown or inky black in color, and there are also colorless nevi that have no color. Pigmented nevi are congenital benign tumors composed of pigmented cells, and most of them are benign; in later stages, there are malignant ones, and once a pigmented nevus becomes malignant, its malignancy is extremely high and its metastasis rate is the fastest, and the treatment effect is not ideal. The disease can be seen in all parts of the skin, with the soles of the feet being the preferred site. For certain pigmented nevi at the site of junctional nevi and those with malignant symptoms, they should be removed in time. There are many types of nevi, generally speaking, no treatment is needed. However, attention should be paid to the pigmented nevus on the plantar and nail beds, so as not to stimulate them casually or apply corrosive drugs indiscriminately to avoid provoking malignant changes. If the nevus increases rapidly within a short period of time, the color deepens and becomes black, the edges become red and irregular, the surface bleeds and breaks, and satellite damage appears around the nevus, it indicates that the nevus has signs of malignant transformation and should be removed surgically and sent for pathological examination at present. Surgical methods generally include toenail bed excision, toe amputation, and local excision flap transfer repair. We have treated many cases with peroneal bunion flap and obtained good results in reconstructing the toenail.