Background: Diabetes mellitus, characterized by chronic hyperglycemia due to insulin secretion defects or resistance, leads to microvascular and macrovascular complications. Diabetic foot ulcers (DFUs), a severe manifestation of these complications, contribute significantly to morbidity and the risk of amputations among diabetic patients. Effective wound management in DFUs is critical, and growth factors like recombinant human epidermal growth factor (hEGF) have shown promise in promoting wound healing through cellular proliferation and angiogenesis. Aim: This study aimed to assess the efficacy of topical recombinant hEGF in enhancing wound healing in diabetic foot ulcers compared to conventional saline dressing. Materials and Methods: In this randomized controlled trial, 80 patients with diabetic foot ulcers were recruited and allocated into two groups: Group A received normal saline dressing with topical recombinant hEGF, while Group B received normal saline dressing alone. Participants were matched for demographic variables including age, gender, and duration of diabetes. Wound size, rate of granulation, and duration of hospital stay were measured at baseline, 7, 14, and 21 days. Data were analyzed using independent t-tests and chi-square tests, with statistical significance set at p < 0.05. Results: The study found that Group A, treated with recombinant hEGF, had a significantly greater reduction in wound size and area compared to Group B. Final wound size and duration of hospital stay were significantly lower in Group A. Staphylococcus aureus was the most commonly isolated organism, followed by Escherichia coli. There were no significant differences in adverse effects between the groups. Conclusion: Topical recombinant hEGF, when used with normal saline dressing, significantly improves wound healing in diabetic foot ulcers, evidenced by reduced wound size and shorter hospital stays. These findings suggest that incorporating recombinant hEGF into standard DFU care protocols could enhance treatment outcomes and potentially lower healthcare costs.