Double nail of the 5th toe is a congenital anomaly where the nail plate splits into two parts, with the medial portion larger. Though not rare, it is underreported due to its often painless nature. Typically bilateral, it may involve toe rotation causing friction, thickening, and misdiagnosis as a callus. The condition is autosomal dominant, with no racial predisposition and a possible female predominance. Diagnosis is clinical, differentiating it from ectopic nails, fibrokeratoma, or traumatic deformities. Treatment is rarely needed but may involve surgical matricectomy or phenolization.