Transmetatarsal amputation (TMA) is a frequently performed procedure for limb salvage in diabetic patients with recalcitrant ulceration, infection, and lower extremity arterial disease. It is imperative that appropriate footgear, inserts, prosthetic devices, and braces are utilized following TMA to prevent recurrent ulceration. This is especially important when severe equinovarus deformity is present secondary to a short residual foot. The authors briefly review the factors implicated in development of equinovarus deformity following TMA. Indications for various types of footgear, prosthesis, braces, and inserts are discussed.