Ill-fitting shoes are a common cause of foot ulceration in people with diabetes mellitus and prescribed footwear is used to prevent and treat such lesions. However, footwear is only effective if worn and the shoes supplied have to be acceptable to the patient. A study of patients who were supplied with footwear at a diabetic foot clinic was conducted using face-to-face interviews and a structured questionnaire, to assess footwear usage and patient preference. Of the 50 subjects who participated, only 11 (22%) regularly wore their prescribed footwear and 19 (38%) subjects wore slippers indoors. Only 12 subjects (24%) were aware of the cost of their shoes. Most subjects were happy with their footwear and the service which was provided, whereas 9 (18%) disliked the style of their shoes and stated that they were not cosmetically acceptable. Thus, although expensive footwear is supplied to patients to prevent and treat foot ulcers, it may not be used as intended. If shoes are to be worn, a wider choice of footwear should be available to the wearer.