Objective: To point out the changing trend of onychomycosis, its common clinical patterns, and etiologic agents and to evaluate the clinicomycologic correlation in the particular region of rural Bengal. Methods: Three hundred and ten cases of clinically suspected onychomycosis were included in this study. Clinical patterns were noted and sample collected from most severely affected nail. They were subjected to direct microscopy, culture and investigated by available resources. Results: Most common Clinical pattern of onychomycosis in our observation is Distal Lateral subungual onychomycosis (63%) followed by proximal subungual onychomycosis type (21%). Dystrophic onychomycosis (12%), white superficial onychomycosis (16 %) and chronic paronychia 12%) were the other variants respectively. We found 162 cases (50.6%) of nail lesions were diagnosed by either microscopy or culture whereas 148 cases (49.4%) were negative by culture. A good number of isolates were yeast (72 samples or 23.22%) which was found to be the most important cause of onychomycosis. Dermatophytes were isolated in 66 samples (21.29%) where Trichophyton rubrum was the most common isolate (37, 11.93%). Nondermatophytic moulds were involved in 20, 6.4% of cases. Conclusion: Onychomycosis, though a neglected condition, might be an important cause of absenteeism especially amongst the working classes in this part of India. Yeasts and nondermatophytic moulds are gradually emerging an important cause of onychomycosis in different areas of the world. So, early diagnosis and treatment is necessary and should be the right approach towards these patients.