Background Diabetes-related foot ulcers (DFU), a severe complication of diabetes, is strongly associated with high mortality. Although the prognostic nutritional index (PNI) has been validated for predicting clinical outcomes, its precise relationship with mortality risk in patients with DFU remains unclear. This study aimed to investigate the association between PNI and all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACE) in patients with DFU, and to elu