Onychomycosis is the most common nail disorder, often causing physical, emotional, and aesthetic consequences. The impact of both the condition itself and treatment on quality of life has not been well studied.The objectives of this study were to systematically review the available literature describing the impact of onychomycosis and treatment on quality of life.We performed a search of the onychomycosis literature published prior to April 13, 2020. Articles were included in the review if primary data were presented, patient-reported outcome measures were used, and onychomycosis was specifically examined.Thirty studies were included in the final analysis. Poorest QoL scores were associated with females and fingernail involvement. QoL scores improved from baseline with all treatment types; there were greater improvements reported with orals compared to topicals.This review affirms that onychomycosis causes significant impact on quality of life, warranting effective treatment. All treatments resulted in quality of life improvements, however studies on oral and topical therapies were of higher quality than those evaluating devices. Increased efforts are needed to understand the impact of the disease and therapy as assessed by validated, nail-specific outcome measure that accurately assess patients' cosmetic, physical and social difficulties.