Subungal glomus tumours are uncommon; the only treatment is complete surgical excision. Transungual approach is often preferred; however, secondary nail deformity may occur. Lateral periungual approach is used to avoid this complication, but this approach provides limited exposure and is used for peripheral lesion only. We describe a modified periungual approach which can be applied to central lesions. This approach can provide adequate exposure for complete excision of the subungual tumour while avoiding incision of the nail bed.