Background <p>Diabetic foot infections (DFIs) are serious complications of diabetes mellitus, leading to significant morbidity, prolonged hospital stays, and potential limb amputation. Diabetic foot osteomyelitis (DFO) is a severe complication that may develop insidiously, often without overt signs of infection due to underlying neuropathy and vascular insufficiency. Early diagnosis and intervention are essential for preventing severe outcomes.</p> Case report <p>The case of an 11-year-old girl with poorly controlled type 1 diabetes mellitus who developed osteomyelitis-associated diabetic foot following trauma to both ankles has been presented. She presented with fever, pain, swelling, and restricted movement in both ankles. Imaging studies, including MRI, confirmed the diagnosis of DFO. Methicillin-susceptible <i>Staphylococcus aureus</i> was identified in purulent fluid drained from the affected areas. Following aggressive antibiotic therapy and surgical intervention, the patient showed significant clinical improvement and was discharged after 40 days of hospitalization.</p> Conclusions <p>Diabetic foot osteomyelitis is a rare but serious condition in the pediatric population, often under-recognized due to its subtle presentation. This case highlights the importance of early imaging and multidisciplinary management to prevent severe complications, including amputation. As the prevalence of diabetes increases in children, awareness of DFO in this age group is critical for timely diagnosis and effective treatment. Diabetic foot osteomyelitis in children is a challenging condition that requires prompt diagnosis and a comprehensive treatment approach. Coordinated care involving early imaging, surgical intervention, and targeted antibiotic therapy is key to preventing severe complications and improving outcomes in pediatric patients with diabetes.</p>