Neuropathic foot ulcers, a serious complication of impaired pedal sensation, are the most common complication of diabetes mellitus leading to hospitalization. One of the goals in treating neuropathic ulcers is to reduce or eliminate pressure from the ulcer site to prevent further breakdown and allow healing. These treatments must address several forms of stress—vertical pressure, shearing force, and tissue strain. This paper reviews several techniques for off-weighting plantar ulcers and describes and recommends the felt-to-foam contact padding technique used at the Northern California Center for the Diabetic and Insensitive Foot and the California College of Podiatric Medicine.