Background: Leg ulcers are debilitating and painful which greatly reducing diabetic patient’s quality of life. A prospective cohort study was done to evaluate the effectiveness of wound healing of ionized nano-crystalline silver and normal saline was assessed.Methods: Diabetic patients presented with foot/leg ulcer were divided into 2 groups of 28 in each group. In group 1 patients, sterile cotton gauze impregnated with normal saline was used. Group 2 patients were dressed with sterile cotton gauze impregnated with ionized nano-crystalline silver. Patients were observed for three weeks or until discharge. The rate of wound healing was assessed in three weeks with serial photographs and measurement of ulcers.Results: Total 60 patients were included in the study. In the group 1, thirty-three patients whose ulcer was dressed with normal saline, the healing rate was 1.2 mm/day with an average value of 0.4 mm/day. The granulation tissue developed was dull red and unhealthy. While twenty-seven patients in group 2, whose ulcer dressed with nano-crystalline silver healing rate was found maximum of 1.5 mm/day with an average value of 0.6 mm/day. The granulation tissue developed was bright red and healthy. The area reduction of wound was significantly different between the groups and maximum was found on 15th day (p=0.001).Conclusions: Wound dressing with ionized nano-crystalline silver was better than normal saline. This suggest the potential use of nano- silver based dressing in diabetic leg and foot ulcer patients.