Charcot arthropathy is a condition that results secondary to sensory loss which is characterized by bone and joint destruction. Sensation can be protective and the absence of this protection leads to repetitive trauma which is believed to be the etiology of this disease process. Several joints in the body are commonly affected such as the joints of the foot and ankle, the elbow, the shoulder, the spine, and the knee. There are several underlying conditions with nerve damage that lead to this condition such as diabetic neuropathy, chronic alcohol use, syphilis, and spinal cord pathology such as syringomyelia. The most common underlying cause of charcot arthropathy in the foot and ankle is diabetes. Patients frequently present with a swollen, erythematous, and warm foot and ankle. This condition can often mimic an infection and it can be difficult to differentiate the two. Management is primarily nonoperative with total contact casting and orthotics such as the charcot restraint orthotic walking (CROW) boot. Neuropathic medications can also provide pain relief. Surgery is rarely performed for this condition given the extremely high complication rate which can ultimately lead to an amputation.