Osteomyelitis is a complex and potentially devastating condition. Appropriate therapy requires a multimodal orthoplastic approach and the cornerstone of treatment is surgical management. The aim is eradication of infection by thorough debridement, leaving only viable tissue and restoring function. Despite the unquestionable need for surgical debridement in chronic osteomyelitis, the need for reliable radiological and tissue diagnosis along with appropriate antimicrobial therapy is paramount for the success of treatment. The route of administration and duration of antimicrobial therapy continues to be debated. The role of biofilm is now clearly established in the chronicity of bone infection, and newer modalities are being developed to address various issues related to biofilm formation. We aim to review the current trends and concepts for treatment of chronic osteomyelitis in this article. This includes the traditional and more novel techniques for obliterating osseous and soft tissue dead space as well as restoring bony stability and function.