Background <p>Recently, a new prognostic classification for foot and ankle Charcot arthropathy (Mansoura Classification) was published. The aim of this study was to evaluate the interobserver and intraobserver reliability of Mansoura classification for foot and ankle Charcot arthropathy.</p> Methods <p>Mansoura classification for foot and ankle Charcot arthropathy was presented to orthopedic surgeons (raters) who participated at Mansoura International Foot and Ankle Course. Thereafter, twenty cases of foot and ankle Charcot were presented to the raters who were asked to rate each case according to the classification. Three weeks after the initial evaluation, six raters from a single institution repeated the rating of the cases. Both interobserver and intraobserver reliability were assessed using Kappa statistics.</p> Results <p>Sixty-one raters completed the evaluation of the twenty cases of foot and ankle Charcot. Their interobserver reliability was moderate (Kappa = 0.5). Intraobserver reliability was excellent for six raters (range, 0.81–0.93). Further analysis of the interobserver reliability of the former six raters who were specialized in foot and ankle surgery showed substantial reliability; Kappa = 0.67.</p> Conclusion <p>Mansoura classification for foot and ankle Charcot has acceptable reliability which is comparable to other classifications. It could be promising in evaluating the severity and guiding the management of such cases.</p> Level of evidence <p>Level IV case series.</p>