The recurrence rate of neuropathic foot ulcers is reported in 51 diabetic patients regularly attending a diabetic foot clinic. All of the patients were provided with protective footwear reducing peak plantar pressure at the forefoot area by 50% (versus normal shoes), and were followed up for up to 4 years. Compliance with this footwear was recorded by assessing the daily time of wearing protective or normal shoes, and compliance with foot care was recorded from the entries in the patients charts. The results of this observational study demonstrate that wearing protective shoes for > 60% of the daytime significantly (p = 0.0002) reduced the ulcer relapse rate by > 50% in comparison with shorter wearing times for these shoes. In addition, patients without ulcer relapses had foot care significantly more frequently than patients with relapse (p < 0.05). It is concluded that cushioned protective footwear in association with frequent foot care is essential in the prevention of neuropathic diabetic foot ulcer recurrence.