Background Diabetic foot infection (DFI) frequently occurs in the context of co-existing peripheral arterial disease, neuropathy and structural foot deformity, and is associated with high rates of amputation and mortality. Surgical management is multidisciplinary but often variably structured across orthopaedic and vascular services. Protocolised pathways have been proposed to standardise care delivery. Aims: To evaluate outcomes of a pulse-based, protocolised orthopaedic–vascular model for the management of DFI. Methods A retrospective cohort study was conducted of 269 patients undergoing operative management for DFI at a single tertiary centre (Jan 2020 to Jan 2022). Patients were triaged via a protocolised pathway according to pedal pulse status into orthopaedic or vascular care streams. Primary outcomes were 12-month all-cause mortality and major amputation. Secondary outcomes included operative burden, length of stay and readmission. Results Overall mortality was 11.9% and major amputation 5.9%. The protocolised model stratified patients into clinically distinct groups. Orthopaedic patients were younger with lower mortality (7.4%) and amputation (4.3%). Vascular patients were older and demonstrated higher mortality (23.9%) and amputation (7.5%). The combined cohort exhibited the highest treatment intensity, with greater operative burden (mean 3.92 procedures), length of stay (median 40 days) and readmission (51.3%). Conclusion A protocolised orthopaedic–vascular pathway provides a structured, multidisciplinary framework for the management of DFI and stratifies patients into clinically distinct groups. Outcome differences observed between pathways are consistent with underlying disease severity, while the combined pathway reflects the intensity of care required for complex limb salvage.