A foot ulcer is a complication that is difficult to treat in people with diabetes mellitus. Over the past few years, both clinicians and scientists have been showing more interest in this condition. A number of factors are involved in the development and maintenance of a diabetic foot ulcer, including: polyneuropathy, mechanical overload, peripheral arterial disease and infection. The cornerstones of treatment are: relief of pressure, the restoration of perfusion ofthe foot, treatment of infection, wound care, optimum glucose regulation and education. New and effective methods of treatment have become available. These include a non-removable plaster cast that is modelled to the form of the foot (a 'total contact cast'), endovascular revascularisation procedures in the lower leg, and topical application of negative pressure.