The treatment of diabetic foot ulcerations has been a difficult task for podiatrists. Numerous methods and materials have been used in an attempt to alleviate this frustrating and complex treatment dilemma. However, there is one treatment method that has been used successfully for decades on plantar ulcerations of the neuropathic foot. Total contact casting has been an easily applicable and effective treatment modality for neuropathic ulcerations of the diabetic foot.