OBJECTIVES: The diabetic foot is a complex late complication, it is difficult to treat and has severe impact on quality of life and causes an enormous financial burden for society. Aim of of this study was to evaluate structured chiropodist care (CC) with regard to healing rates and costs provided by intensively instructed professionals. METHODS: One year follow-up-data of a randomized and controlled trial (RCT) performed in the province of Styria, Austria showed significantly reduced reulceration rates under chiropodist care. Patients in the intervention group received chiropodist care in average 11 times per year and were reimbursed for the costs (€29 per visit). Based on a published paper Austrian specific cost data of 2001 were used to build a Markov Model to evaluate 10 years outcome. A Monte-Carlo-Simulation (n=10.000) was performed for patients with chiropodist care (intervention) and no chiropodist care (control). RESULTS: Mean follow-up-duration for 91 patients of the RCT was 386 days with a reulceration rate of 36% in the intervention group (n=47) and 55% in the control group (p=0,05). The model calculation over 10 years showed treatment costs per patient of € 12,094 (SD 13,379) in the intervention and €18,538 (SD 16,120) in the control group. Costs for the general treatment of diabetes were not taken into account. The amputation rate under intervention declined to 40% versus 67% in the control group. Taking the mean life expectancy into account (6.1 ys. vs. 5.1 ys.) average costs per patient-year were 1.985 € in the intervention group versus €3.654 in the control group. CONCLUSION: The model based analysis demonstrated the benefit of CC over a 10 year period in terms of reduced amputation rates and lower costs per patient and year.