By the time you finish reading this paragraph, it is likely that at least one person has lost part of a foot or leg through diabetic foot disease. This happens every 30 seconds. An amputation is often preceded by an ulcer; 15% of people with diabetes are affected by a foot ulcer at some time in their life. With the global diabetes population set to rise to 333 million by 2025, there is an urgent need for a co-ordinated preventive clinical response to reduce the impact of the diabetic foot. Up to 85% of all diabetic-foot-related problems are preventable through a combination of good foot care and appropriate education for both people with diabetes and health-care providers. Kristien Van Acker and Ali Foster describe a step-wise approach to establishing a foot clinic, which can support health-care providers in achieving excellence in diabetes foot care.