A woman with poorly controlled Type 2 Diabetes Mellitus and morbid obesity presented with infected gangrene of the great toe. Despite the severity of the infection, careful clinical and intraoperative assessment confirmed that the underlying phalanges remained viable, allowing a limb-sparing approach without bone resection.

Serial surgical debridements were performed, removing all necrotic and infected soft tissue until healthy, bleeding margins were achieved. All phalanges and the entire toe were preserved, as no osseous resection was required.

The wound healed progressively with complete resolution of the infection. The entire toe and all underlying bones were preserved, maintaining toe length, stability, and function while avoiding amputation.

This case demonstrates that even infected toe gangrene does not necessarily require bone resection or toe amputation; meticulous surgical debridement and careful assessment of bone viability can achieve complete toe preservation.