Heel ulcers are often caused or delayed in their healing by some form of external pressure, either walking or static pressure. To promote wound healing, the heel ulcers require off-loading modalities such as heel casts (Lewis and Lipp, 2013). Although commonly used across the UK, there is currently limited guidance for the use of heel casts. The evidence for use is low but in practice and through small-scale case series heel casts have been shown to improve healing times (Stuart et al, 2008; Dagg, 2013). An expert group from North West Podiatry Services working predominantly in wound care discussed and agreed current practice and knowledge in order to produce a guideline that offers a consensus agreement on the use of heel casts in practice. It is intended to give advice on safe and appropriate use and a method of application for heel casts in relation to heel ulcers; this article provides an introduction and an overview of the guideline.