Diagnosing Charcot neuroarthropathy requires a heightened index of suspicion. Early recognition and intervention can limit deformity. Aggressive conservative management should be initiated early in the treatment plan to minimize the devastating effects often seen with this condition. Any delay in therapy can result in severe foot and ankle deformity in which traditional nonoperative methods alone may be inadequate. These deformities may lead to ulcerations and ultimately progress to amputation of the lower extremity. Surgical correction and stabilization is an effective method to prevent further deformity and ulcer recurrence. If performed in the appropriate setting and for the right indications, Charcot foot reconstruction is a better alternative to lower limb amputation.