Background: If unrecognized, Charcot neuro-osteoarthropathy (CNO) can be a devastating complication of diabetes. Methods: The aim of this retrospective study was to evaluate the outcomes in a cohort of diabetic patients diagnosed with active CNO managed in a tertiary level diabetic foot clinic (DFC). We included consecutive patients with active CNO, stage 0-1, according to the Eichenholtz-Shibata classification, who were referred from 1/Jan/2019 to 27/Sep/2022. Diagnosis of CNO was based on clinical signs and imaging (X-rays and magnetic resonance). All patients were completely offloaded by a total-contact cast (TCC) or removable knee-high device. Each patient was closely monitored monthly until CNO remission or another outcome. At 12 months of follow-up, the following outcomes were analyzed: remission, time to remission, major amputations (any above the ankle), and surgical indication. Results: 43 patients were included. Mean age was 57.6±10.8 years; 65% were males and 88.4% had type 2 diabetes, with a mean duration of 20.6±9.9 years. At baseline, 32.6% was affected by peripheral artery disease. 16/43 patients were classified as Stage 0 (37.2%). Complete remission was recorded in 40/43 patients (93%; Stage 0: 100% vs Stage 1: 88.9%, p=0.03), with a mean time to remission of 5.6±1.5 months (Stage 0: 3.6±0.9 vs Stage 1: 6.7±1.8, p=0.01); major amputation and surgical indication occurred only in Stage 1 patients (respectively: 1/43 patients [2.3%] and 3/43 patients [7%]). Conclusions: Early treatment of active Stage 0/1 CNO leads to high rates of remission and limb salvage at one year.