Arthrodesis of the ankle for diabetic complications such as Charcot neuroarthropathy (CN) and osteomyelitis is a distinct entity that requires various surgical techniques for optimal outcomes. When comparing external fixation and ankle arthrodesis nail-mounted compression devices, higher compression is reached and maintained in the case of the ankle arthrodesis nail-mounted compression device. Aim of the study: The current study aimed to assess both functional and clinical outcomes of retrograde intramedullary locking nailing of ankle arthrodesis in diabetic arthropathy patients, as regard alignment, function, union, and rate of complications. Patients and methods: This is a prospective clinical research including 12 diabetic individuals who had advanced ankle and subtalar joint instability and/or deformity due to ankle arthropathy. Patients underwent ankle arthrodesis using retrograde intramedullary locking nail to evaluate the clinical and functional outcome of retrograde intramedullary locking nailing of ankle arthrodesis in diabetic arthropathy patients, including function, alignment, union, and complication rate. Results: The union duration of the studied group was (9.4±2.1) weeks ranged, most of the studied group (83.3%) had healing time. There was a highly statistically significant improvement in all items of the AOFSA Score post-operatively, mainly AOFSA pain, function, and alignment. About two-thirds (75.0%) of the studied group did not have pain post-operatively, (16.7%) of them had mild pain, while only (8.3%) of them had moderate pain. Almost all (91.7%) of the studied group did not have any difficulty on any surface, (8.3%) had some difficulty, and no one (0.0%) had severe difficulty. Most (83.3%) of the studied group had a normal gait, (16.7%) had obvious gait abnormality, and no one (0.0%) had marked gait abnormality. The entire studied group (100.0%) had severe restricted sagittal plane motion without any flexion or extension. Most of the studied group (83.4%) did not have any complications, (8.3%) of them had Periprostatic fracture and (8.3%) had superficial infection. Conclusion: The current study established that ankle arthrodesis with a retrograde intramedullary locking nail is an exceedingly successful salvage method for diabetic individuals with ankle and hindfoot problems. This technique results in a high level of functional improvement and pain reduction. When performed properly, it is a relatively safe procedure with favorable clinical results and a minimal chance of below-knee amputation. Keywords: Ankle Arthrodesis, Retrograde Intramedullary Locking Nail, Diabetic Patients