Docetaxel is a commonly-used anti-cancer chemotherapeutic agent given its efficacy in a large varlety of solid tumors. It is associated with various adverse effects one of which is nail toxicity. We report a case of severe onycholysis as a result of treatment with docetaxel in a patient who suffered from metastatic nasopharyngeal carcinoma. The case report will be followed by a discussion on the possible mechanism and preventive strategies for taxane-induced nail toxicity.Taxane including both paclitaxel and docetaxel has been used extensively in the past decade for the treatment of many types of solid malignancies. It is associated with specific adverse effects including neuropathy, myalgia as well as higher incidence of allergic reaction. Nail toxicity is a relatively common adverse effect of taxane that can be easily neglected by oncologists whose primary focus is tumor response to therapy. We report a case of severe nail toxicity as a result of docetaxel treatment in a patient who suffered from metastatic nasopharyngeal carcinoma.