This article will examine what is known about the epidemiology of diabetic foot disease in Indigenous people and what strategies have been used to manage the problem. The prevalence of diabetes is several-fold higher in Indigenous people compared with non-Indigenous people. The prevalence of diabetic peripheral neuropathy varies but in general it appears to be more common and start at a younger age in Indigenous compared with non-Indigenous people. Peripheral artery disease is also more prevalent and the incidence of lower extremity amputation is higher. Various strategies have been shown to be effective in the delivery healthcare for diabetic foot disease in Indigenous people. There are, however, social and political barriers to the implementation and success of these interventions.