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A total contact cast (TCC) is considered the gold standard for healing diabetic foot ulcers (DFU). Numerous studies have demonstrated the excellent healing success of a TCC; however, its adoption in routine clinical use does not match its success rate. This lack of implementation is due to several factors: Medicare's payment structure, lack of clinical training, and a variety of patient factors. These factors have reduced clinicians' use of TCC to approximately 25% of DFU. The aim of this review was to analyze and demonstrate common scenarios for outpatient wound centers where a TCC may be beneficial to both patients and hospital systems, and to expand its usage to more closely reflect its healing success rate. .