Background and aim of the work: Foot ulcers are a major problem of diabetes for which conventional treatment modalities alone have had limited success in promoting complete wound closure; however, there are large amounts of evidences that exist for the effectiveness of manuka honey as a wound dressing especially in diabetic foot. The aim of this study was to compare the efficacy of Manuka honey combined with conventional modalities to that of conventional treatment alone in the treatment of diabetic foot ulcers. Patients and Methods: This was a prospective double-blind, randomized clinical trial conducted at the King Abdul Aziz Specialist Hospital in Taif, Saudi Arabia. Fifty-nine patients, enrolled from January 2011 to January 2013, were randomized to receive conventional treatment plus manukahoney impregnated dressings (honey treatment group) or conventional treatment alone (control group). Outcomes were; time to eradicate infection, length of hospital stay, percentage of completely healed ulcers after six weeks and six months. Results: The mean time to eradicate infection and the hospital stay were significantly reduced in the honey treatment group compared to control group (51.1% and 53.8% respectively, P<0.05). Percentages of ulcers that were completely healed were significantly greater in the honey group than the control group, at six weeks (61.3% vs. 11.5%; P <0.05) and at six months (87.1% vs. 42.3%; P<0.05). There were less toe amputations in the honey-treated group (9.7% vs. 34.6%; P<0.05). Conclusion: Combination of conventional treatment with manuka honey impregnated dressings is superior to conventional treatment alone in controlling wound infection, promoting the complete healing of diabetic foot ulcers, and decreasing the rate of minor amputations.