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BACKGROUND: Onychomycosis is the most common disease of the nail apparatus, laboratory diagnosis routinely includes direct exami-nation with KOH and cultures, but its sensitivity and specificity are variable, this is influenced by the mycologist's experience and by the performance of one or more serial studies. OBJECTIVE: To determine whether conducting serial mycological studies in patients with clinically suspected feet onychomycosis increases the detection of the disease. MATERIAL AND METHOD: A descriptive, prospective, longitudinal study was conducted, 154 patients were included with clinical suspicion of feet onychomycosis. All patients underwent a first direct examination with KOH and mycological culture (Sabouraud dextrose agar with and without antibiotics) for diagnostic confirmation. Patients that presented negative results on examination underwent these same tests with a maximum of 3 times. RESULTS: Of the 154 enrolled patients diagnostic confirmation was obtained by direct and/or mycological culture in 62% in the first study, 78% with two studies and 82.5% after three serial mycological studies. Finally 27 patients persisted with negative results. The most common clinical presentation was total dystrophic onychomycosis found in 62% of patients and the most frequent isolated fungus was Trichophyton rubrum in 55%. CONCLUSIONS: In patients with clinically suspected onychomycosis, we recommend performing two mycological studies, leaving to the discretion of the physician the request of a third study. [ABSTRACT FROM AUTHOR]