A woman aged 82 years was referred to hospital by her general practitioner with a non-healing foot ulcer. The ulcer had been present for over 18 months and had been treated unsuccessfully by district nurses for the past 12 months. In the past three months it had become increasing painful, interfering with walking. Doppler studies had confirmed that it was a venous ulcer. Unfortunately the patient had been unable to tolerate four layer compression bandaging. When the patient was admitted the ulcer was covered by a mixture of thick, black, dead tissue and infected yellow green slough. Initial treatment with Intrasite gel (hydrogel) was unsuccessful. She was treated with sterile larvae applied to the foot ulcer for three days (figure 1). After removal of the larvae the foot ulcer continued to improve and was healed within three weeks.