Background: Diabetic foot is a broad spectrum term which includes infection, ulceration and foot gangrene. Proper assessment of wound along with an aggressive multidisciplinary approach can reduce the risk of limb amputation. Wound dressings play an important role in diabetic foot care management. Nano crystalline silver ion dressing is a newer modality that has been in consideration for the treatment of diabetic wounds. Aim: This study was aimed to compare on the wound healing effectiveness of with normal saline and ionized nano-crystalline silver dressing among chronic diabetic foot ulcer patients. Material and methods: A Prospective study was conducted in the Department of General Surgery, Patna Medical College and Hospital, Patna, Bihar, India for 15 months. Total 80 diabetic patients with leg and foot ulcers with age 20 to 75 years were include in this study. In 40 patients, ionized nano-crystalline silver dressing was given. In another 40 cases, normal saline was used for wound dressing. Area of the ulcer, development of granulation tissue and size of the ulcer were measured over 2 days interval. Each patient was studied for three weeks or until discharge of the patient. Results: Total 80 diabetic patients were included in the study. No statistically significant difference could observe among any of the demographic details between the groups. 40 patients were included in the group 1 whose ulcer was dressed with normal saline. 40 patients included in the group 2, whose ulcer were dressed with ionized nano-crystalline silver. Reduction width of wound on 15th day was found to be almost double in the ionized nano silver dressed group when compared to the normal saline group (p=0.001). The mean areas of reduction of wound on 15th day in the saline and ionized nano silver dressings were 22.36±10.37 and 40.58±19.87, respectively. The areas of reduction of wound on the 1st day of dressing were 1.39±0.73 and 2.77±1.41, respectively in the normal saline and ionized nano crystalline silver dressed groups. All the parameters were found statistically significant between the groups (p<001). The healing rate was found maximum of 1.6 mm/day with an average value of 0.7 mm/day in the silver dressed group. In the group 1 patients where the ulcer was dressed with normal saline; the healing rate was found 1.3 mm/day with an average value of 0.5 mm/day. The dull red and unhealthy observation was found in the normal saline treated group while in the ionized nano crystalline silver treated group, the granulation tissue was bright red and healthy. The percent reduction of ulcer with ionized nano crystalline silver was 2.82% per day and with normal saline dressings is 1.39% per day, which was significant (<0.001). Conclusion: we conclude that the nano-crystalline silver, a cost-effective agent as an early intervention in the management of diabetic foot ulcer along with systemic antibiotics to reduce the rate of amputations.