The use of autologous grafts in the reconstruction of nail-bed injuries is a topic that has received variable attention in the literature. With the exception of a few sentinel articles with large patient cohorts, most techniques have been reported with only anecdotal clinical support. Nail grafting remains, however, a subject that is extremely important in the total care of hand injuries. Grafting is one of the only reconstructive modalities for a majority of nail-bed injuries with avulsed tissue as well as for chronic, scarred nail deformities. We review the literature and summarize the techniques available for a variety of circumstances.