Purpose First Nations Aboriginal and Torres Strait Islander people have a higher prevalence of diabetic foot disease and consequent major limb amputations in Australia. Our aim is to examine the outcomes of Aboriginal and Torres Strait Islander patients undergoing toe amputation for diabetic foot disease (DFD) in comparison to others and identify contributing risk factors for less favourable outcomes. Methodology A retrospective cohort study was conducted in Cairns Hospital amongst inpatients of the vascular surgery unit who were admitted for management of DFD from 1st of January 2015 to 31st of December 2024. Primary outcomes were requirement of further foot debridement and/or minor amputations following index procedure and subsequent ipsilateral major limb amputation. Secondary outcomes included all-cause post-operative mortality and perioperative incidence of MACE. Results 231 patients were included over a period of 10 years. Aboriginal and Torres Strait Islander residents represent 12.6% of the Cairns and Hinterland Hospital and Health Service (CHHHS) population. In our cohort, 48.1% were of this background. In comparison to other patients, Aboriginal and Torres Strait Islanders had a significantly lower median age of presentation to hospital (p = 0.016), significantly higher likelihood of requiring further digital amputation/s (p = 0.002), and a significantly shorter duration of time before re-presentation for a recurrent minor amputation (p <0.02) following the index minor amputation. This affected males and females almost equally (55.8% and 44.2%), in contrast to males being more affected in other patient groups. Conclusion This is one of the largest representations of Aboriginal and Torres Strait Islander patients in current Australian literature looking at outcomes following minor amputations in patients with DFD. There is a notable over-representation and significant discrepancy in outcomes among Aboriginal and Torres Strait Islander peoples in comparison to others with DFD.