Dermatophytes typically cause onychomycosis, which accounts for 50% of all nail diseases. Although formerly thought to be a cosmetic issue, it has recently gained attention because of its chronic nature and challenging treatment with relapses. Due to the lengthy treatment period and high expense associated with treating onychomycosis, numerous attempts have been made to overcome the hard nail barrier. Oral and topical medications are traditional treatments for onychomycosis. Despite their effectiveness, oral antifungal medications have hepatotoxic effects and can be mixed with other medications. Topical therapy improves patient compliance because it has no negative side effects. However, improper nail penetration poses a problem. Therefore, the goal of enhancing topical administration to effectively treat onychomycosis has been pursued for decades. Despite all efforts, issues with nail delivery have not been much closer to being resolved. Recently, the focus has shifted to novel drug delivery technologies, such as polymeric films, metallic nanoparticles, microemulsions, and nail lacquers, to enhance drug penetration and localized therapy. A global study is investigating their potential as efficacious treatment modalities. Thus, the goal of this review is to learn about innovative delivery methods for the treatment of onychomycosis, a persistent fungal disease.