This study analyses 2848 primary major lower limb amputations in diabetic individuals during the period 1982-1993. The male:female sex ratio (mean 1.18) increased, while the mean age at the primary amputation was constant (70.96 years) during the period. The incidence uniformly decreased for both men and women by 0.96 per year. A subdivision of the total population into three age groups (< 50, 50-70, > 70 years), shows a 0.95 decrease per year with no significant difference between the groups. The decrease in incidence during the period 1987-1993 appeared specifically related to insulin-dependent diabetes mellitus (0.92), whereas the incidence of amputations in non-insulin-dependent diabetic patients was constant. The overall decrease of incidence during the period (40%) does not fully meet the target specified in the St. Vincent Declaration.