Objective Itraconazole pulse therapy is at lest as efficient as itraconazole continuous treatment for onychomyocsis, but the long term oral antimycotic therapy has potential hepatotoxicity.Methods 40% urea paste was thickly applied to each affected nail which was dressed by three cloth adhesive tapes. The urea paste was changed every day or every other day for 5 to 7 days. The sick softened nails were scraped off thoroughly with razer blade. After sick nails were removed, all patients received 200 mg of itraconazole twice a day for seven consecutive days. Results Fingernail onychomycosis were cured in 93% (130/140), markedly improved in 6.4% (9/140). Toenail onychomycosis were cured in 82% (29/35), markedly improved in 17.1(6/35). And in a 18 month follow up period, 16(10 2%) of 147 patients had relapses. Conclusion The treatment of onychomycosis with oral itraconazole plus nail scraping is as effective as that of itraconazole pulse therapy but has less side effect and lower cost.; Objective Itraconazole pulse therapy is at lest as efficient as itraconazole continuous treatment for onychomyocsis, but the long term oral antimycotic therapy has potential hepatotoxicity. Methods 40% urea paste was thickly applied to each affected nail which was dressed by three cloth adhesive tapes. The sick paste was changed every day or every other day for 5 to 7 days. The sick softened nails were scraped off thoroughly with razer blade. After sick nails were removed, all patients received 200 mg of itraconazole twice a day for seven consecutive days. Results Fingernail onychomycosis was cured in 93% (130/140), markedly improved in 6.4% (9/140). Toenail onychomycosis was cured in 82% (29/35), markedly improved in 17.1 (6/35). And in a 18 month follow up period, 16 (102%) of 147 patients had relapses. Conclusion The treatment of onychomycosis with oral itraconazole plus nail scraping is as effective as that of itraconazole pulse therapy but has less side effect and low er cost. ;