The St Mary’s Hospital site of Imperial College Healthcare NHS Trust in West London is home to a multidisciplinary diabetic foot clinic. In this article, the clinic’s Consultant reports some of the team’s achievements, including a reduction in diabetes-related amputation and the establishment of a successful care pathway for the conservative management of neuropathic ulceration complicated by osteomyelitis. The difficulties (and some methods for overcoming them) of calculating diabetes-related amputation rates in the London population are described....