The global prevalence of diabetes is predicted to double by the year 2030 from 2.8% to 4.4% (1). Of individuals with diabetes, a substantial number will develop lower extremity disease including peripheral neuropathy, foot ulcers, and peripheral arterial disease (PAD). In this chapter, the current epidemiology of lower extremity disease in individuals with diabetes is reviewed with a focus on foot ulcers. Population-based and hospital discharge survey data from several sources illustrate the magnitude of the problem in the United States. Analytic and experimental studies conducted in several countries, which used robust multivariable modeling techniques, are discussed to describe foot ulcer risk factors. The chapter concludes with information on the economic impact of lower extremity disease, primarily diabetic foot ulcers.