Orthopaedic surgery has a crucial role in the management of diabetic foot ulceration and Charcot foot. There is a need to raise awareness of the orthopaedic surgeon as an important member of the multidisciplinary team in the surgical treatment of these diabetic foot complications. This article describes three vital roles of the orthopaedic surgeon: surgical management of deformity; treatment of neuropathic diabetic foot infection; and management of Charcot foot deformity. With high-quality surgical care provided by dedicated orthopaedic surgery, the outcomes of diabetic foot ulceration and Charcot foot can be very favourable.