<p>Diabetic foot syndrome (DFS) is a severe consequence of diabetes mellitus, which is often caused by peripheral neuropathy, incorrect weight-bearing, peripheral arterial occlusive disease (PAOD) and infections. In the course of the disease, chronic, poorly healing wounds and amputations occur, which severely impair the quality and length of life of those affected. Treatment requires an interdisciplinary approach. The aim is to prevent or heal wounds in order to avoid amputations. Orthopedic footwear technology plays a key role in this by preventing foot lesions and recurrences. The categorization into risk classes is not only a valuable guide for doctors and orthopedic shoemakers but also for cost bearers when it comes to stage-appropriate shoe care, which has now also been incorporated into the national treatment guidelines. This article summarizes the most important information on classification and shoe fitting for DFS.</p>