Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complication of diabetes and results from chronically high blood glucose. It is one of the most frustrating and debilitating complications of diabetes because of the pain, discomfort and disability. Usually more than 50% of patients with duration of diabetes of 25 years or more are affected, making it as one of the most common disease of the nervous system. One of the largest published series reported a prevalence of 7.5% even at the time of diagnosis of diabetes. Some patients find some relief from neuropathy by keeping blood sugars as closely controlled as possible, getting regular exercise and keeping their weight under control. Surprisingly, clinicians have also found that certain antidepressants may be helpful and can take the edge off the pain of neuropathy. To diagnose diabetic neuropathy, the foot and ankle surgeon will obtain the patient’s history of symptoms and will perform simple tests on the feet and legs which include assessment of the patient’s reflexes, ability to feel light touch, and ability to feel vibration. The mechanisms involved in the development of diabetic neuropathy include changes in the blood vessels that supply the peripheral nerves; metabolic disorders, such as the enhanced activation of the polyol pathway; myo-inositol depletion; and increased non-enzymatic glycation. Treatment includes the most effective antidepressants as tricyclic antidepressants, selective serotonin reuptake inhibitors, and serotonin nor-epinephrine reuptake inhibitors. Clinical studies of diabetic neuropathy indicate that the first line treatment should be tricyclic antidepressants, which are followed by anticonvulsants and then opioids. In this review, we will discuss on diabetic neuropathy and its current treatment strategies