Purpose: Diabetic heel ulcers (DHUs) are a challenging subset of diabetic foot ulcers (DFUs) due to their anatomical location and poor vascularity, leading to delayed healing, increased infection risk and high likelihood of progression to major limb loss. Conventional wound management strategies frequently fail, underscoring the importance of adjunctive therapies that promote healing and preserve tissue, such as maggot debridement therapy (MDT). This study aims to assess the utility of MDT in DHU management through a review of current relevant literature. Additionally, we report a retrospective single-centre case series of three patients with DHUs managed with MDT. Methodology: A literature review was conducted using MEDLINE and Embase databases to identify studies reporting outcomes of MDT on DFUs (n=279), with a specific focus on its application on DHUs (n=16). Results: Our literature review identified 279 studies discussing MDTs in DFUs, with only 16 studies focusing on DHUs. The existing literature supports MDT as a safe and effective adjunct in DFUs. Clinically, MDT achieves rapid and selective debridement, effectively clears infections, and plays a critical role in limb salvage. It is included in multidisciplinary wound care protocols, often in conjunction with surgical debridement, negative pressure wound therapy and advanced dressings. However, data specific to DHUs remains sparse in current literature. In our case series (n=3), adjunctive MDT facilitated selective debridement of non-viable tissue and infection control, resulting in healthy granulation of wound beds, and progressive wound healing. All patients in our case series have avoided major limb amputation with the use of MDT for DHUs. No adverse events were reported. Conclusion: MDT is a promising adjunct for managing DHUs, with a potential to reduce the need for major limb amputations. Although high-quality evidence remains sparse, both the existing literature and this case series underscores the value of MDT in limb salvage strategies. Future prospective studies are needed to validate these findings, with a particular focus on its use in DHUs.