Acute foot disease is a serious, multifactorial complication of diabetes associated with a substantial risk of limb loss and mortality Prompt surgical evaluation and appropriate intervention are critical to prevent limb loss and progression to sepsis/death International Working Group on the Diabetic Foot (IWGDF) and Infectious Diseases Society of America (IDSA) guidelines should be used to stratify severity Empirical, broad-spectrum intravenous antibiotics should be started immediately Severe diabetic foot infection poses a significant threat to life and limb that where indicated requires immediate surgical intervention