Too many of the nearly 200 million people in the world with diabetes suffer from diabetes-related foot complications. As a result, the impact on their quality of life is massive. The loss of a foot or part of a leg is the devastating end result of one of the most feared complications of diabetes. At the same time it places important demands on health-care systems in terms of manpower and costs. In this article, Karel Bakker reports on the world's largest meeting for health-care workers in the field, the 4th International Symposium on the diabetic foot, held in May 2003 in Noordwijkerhout, the Netherlands.