Background: Charcot neuroarthropathy (CN) is a progressive, non-infectious disorder characterized by bone and joint destruction, most commonly seen in patients with diabetes and peripheral neuropathy, and can lead to joint instability, ulceration, osteomyelitis, and increased risk of amputation. The purpose of the study is to evaluate the effectiveness of Ilizarov-assisted ankle arthrodesis in achieving stable fusion and functional outcomes in patients with Charcot neuroarthropathy. Methods: This prospective observational study was conducted at the Department of Orthopaedics, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) along with selected private hospitals, Dhaka, Bangladesh, from January 2020 to December 2024, and included 15 patients with Charcot neuroarthropathy of the ankle. All patients underwent Ilizarov-assisted ankle arthrodesis, and outcomes including fusion, limb salvage, complications, and functional recovery (AOFAS score) were assessed over a mean follow-up of 24.5 ± 6.3 months. Results: Fifteen patients with Charcot neuroarthropathy underwent Ilizarov-assisted ankle arthrodesis. Ankle fusion was achieved in 80.0%, limb salvage in 86.7%, and limb shortening occurred in 73.3%. The most common complication was pin-tract infection (40.0%). Among surviving patients (n = 13), mean follow-up was 24.5 months, AOFAS scores improved from 36.8 to 68.9, and 69.2% achieved full weight-bearing. Conclusion: Ilizarov-assisted ankle arthrodesis provides reliable fusion, effective limb salvage, and meaningful functional improvement in patients with Charcot neuroarthropathy despite procedure-related complications.