<p>Infections are common in diabetic foot wounds and, for the majority, the way infection should be treated is straightforward. However, there are some considerations that need to be taken into account, such as the presence of peripheral vascular disease, that may make judging the severity of an infection more difficult. In addition, the challenges in diagnosing osteomyelitis can make it difficult to choose the best antimicrobial agent. Finally, the most widely used guidelines do not consider admissions avoidance, a situation that clinicians in busy foot clinics meet on a regular basis. This article discusses each of these issues and what impact they have on managing these patients.</p>