Puncture wounds often appear benign but can cause significant pedal morbidity. Podiatric physicians who treat such wounds should educate local emergency room, urgent care center, and primary care physicians as to the potential complications associated with puncture wounds. Timely referral, recognition of the potential complications, and appropriate treatment ensure that the wound does not advance beyond a puncture wound. If complications have developed, aggressive treatment is required to eradicate the infection and prevent pedal amputation. © 2012 Elsevier Inc.