SINCE Nelaton (1852) described a neuropathy with chronic ulceration of the feet in 1852, a number of different forms of mutilating neuropathy have been identified. The common underlying feature in these disorders is a profound loss of pain sensation. Over the years these patients develop chronic ulceration and suppuration in their fingers and toes with destruction of the underlying bones, and most develop neuropathic joint degeneration (Charcot joints). This paper describes two sisters with this clinical appearance, due to a congenital sensory peripheral neuropathy.