Charcot of the calcaneus, although not as prolific as midfoot deformation, still results in significant morbidity. Current treatment centers on methods proven effective for other joints in the foot. Most neuropathic conditions of the calcaneus can be managed reasonably nonoperatively. In cases of severe deformity or ulceration, surgical management may be the more conservative approach. The surgical principles of proper soft tissue balancing and handling are critical. As the diabetic population continues to increase, the incidence of Charcot of the calcaneus will concomitantly increase. Further research into methods of arthrodesis and osteotomy with external fixation seem to be the direction of the future.