Every 2 years, Great Malvern, a small town in the county of Worcestershire, England, is home to the oldest international meeting on the diabetic foot that started about a quarter of a century ago. The 12th Malvern Diabetic Foot meeting, held from May 14 to 16, 2008, was attended by delegates and speakers from 5 continents and more than 25 countries. Strategic clinical specialties involved in diabetic foot management were prominently represented. Virtually every aspect of diabetic foot care was covered during this 3-day meeting through invited plenary lectures, practical interactive workshops, and scientific oral presentations. The evidence base underpinning current foot care was critically appraised, and topical issues on the diabetic foot were revisited. This review puts together key messages emanating from the meeting. All effort has been made to highlight clearly where consensus exists as well as outline areas where controversy persists.