The rapid demographic changes occurring in the Pacific island countries, including Papua New Guinea, have led to a rapid increase in the prevalence of non-communicable diseases. Surgical services in Papua New Guinea are seeing a marked increase in admissions for diabetic septic foot (DSF). Lower extremity amputation is common, although specific criteria for this procedure are lacking. We report a prospective case series of 20 patients admitted to the Surgical Ward of Nonga General Hospital with DSF from October 2013 to July 2014. Patients who had lower extremity amputation were younger, had a higher level of HbA1c and a higher Wagner ulcer score than those managed conservatively.