Charcot arthropathy represents a potentially devastating complication in patients with diabetes; this is most significant when an ulcer and/or infection are present. When conservative therapies fail to relieve symptomatology, amputation usually represents the next step in the treatment algorithm. However, in appropriate patients, reconstructive procedures performed by specially trained surgeons may change this paradigm and prevent amputation. The following case report and subsequent literature review discusses a patient with a recalcitrant ulcer mitigated by severe Charcot foot deformity who underwent surgical intervention leading to preservation of the limb. The goal of this manuscript is to heighten awareness of this surgical alternative and foster the wound healing clinician to seek out surgeons in their communities with the skills and experience to perform these limb preservation procedures and potentially forestall amputation. .