The Charcot joint, or Charcot neuroarthropathy, is a syndrome that was described over 140 years ago but one with very little exposure in the neurologic literature. We present a case recently seen and then discuss the history, epidemiology, pathophysiology, clinical features, and diagnosis of acute and chronic Charcot joint disease with particular emphasis on the value and limitations of imaging. A diagnostic algorithm is proposed. We also review the therapeutic strategies available for acute and chronic Charcot joints with a treatment algorithm. This review is aimed at enhancing the awareness of neurologists regarding Charcot neuroarthropathy, because they are often the principal caregivers for patients with peripheral neuropathy. We hope to promote early detection of acute Charcot neuroarthropathy, thereby reducing or preventing the bony deformation of chronic Charcot neuroarthropathy.