Purpose: This is the first reported case where Biodegradable Temporising Matrix (BTM) has been used in nail bed reconstruction. A 69-year-old woman presented with a right ring finger Squamous Cell Carcinoma (SCC) of the nail bed. Surgical treatment typically involves excision of the tumour, providing there is no bone invasion, which would mandate amputation. Achieving an adequate deep margin requires periosteal excision and thus exposure of the distal phalanx. Reconstructive options include full thickness skin grafts or nail bed grafts, which are of dubious reliability when placed directly onto bony cortex, or staged flaps from adjacent digits which can results in significant stiffness. We utilised BTM as a dermal substitute followed by a staged split thickness skin grafting. Method: Our patient presented with biopsy-proven poorly differentiated SCC. Preoperative imaging confirmed no bone involvement. Initial surgery involved complete nail bed resection down to the bare bone, followed by first stage BTM application. Histological analysis confirmed excision with sufficient margins. After four weeks, the second stage involved delamination and split-thickness skin grafting. Results and Conclusion: One week post-operatively, the graft had taken 100%, yielding an excellent outcome. The use of a dermal substitute in this setting enables pathological confirmation of adequate margins and prevents desiccation necrosis of the distal phalanx whilst awaiting reconstruction. Healed appearances mimic the native nail complex, and providing a dermal reconstruction may enhance durability, improve graft take and improve pulp to nail sensory feedback. This case highlights the potential of BTM in nail bed reconstruction.