Diabetic foot disease, or ulceration, is prevalent and is associated with high rates of lower limb amputation and mortality. Its underlying aetiology is complex and multifactorial. However, neuropathy and peripheral arterial disease represent two important precipitating risk factors. Regular, comprehensive foot examinations are important in the prevention of ulceration and cardiovascular complications as they provide an opportunity to assess risk, modify risk factors and deliver patient education. Charcot neuropathic osteoarthropathy is commonly misdiagnosed and should always be suspected in an individual with diabetes presenting with a hot and swollen foot. Diabetic foot ulcers are challenging to manage. The key to optimizing outcomes includes early diagnosis with referral for coordinated multidisciplinary care where prompt treatment of infection and peripheral arterial disease, as well as appropriate wound care and offloading can be initiated and monitored.