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Introduction Diabetic foot ulcers (DFUs) present significant challenges in clinical management. Numerous studies have confirmed the effectiveness of honey in promoting the healing of cutaneous ulcers of various etiologies, including DFUs. The aim of the study is to compare the effectiveness of DFUs treatment with Manuka honey with the use of a classic silver-based dressing. Methods A randomized controlled trial was conducted involving two groups of patients (a total of 60 individuals) with DFUs. Patients were randomly assigned to two groups: the experimental group received treatment with medical-grade Manuka honey, whereas the control group was treated with a silver-containing calcium alginate dressing. The investigated Manuka honey product was reported with full device identifiers to ensure clinical-grade product traceability. RESVECH 2.0 Scoring Table was used twice (just before procedure and after 4 weeks) to assess treatment effectiveness. It is a validated multidimensional scale designed to assess and monitor the progression of chronic wound healing across key clinical parameters. Results With the exception of Depth/Tissues Involved, all evaluated parameters of RESVECH 2.0 Scoring Table demonstrated a significantly greater improvement in the experimental group compared with the control group (p < 0.001). Total score was reduced by 41.3% in the experimental group vs. 2.0% in the control group. Statistically significant, mostly positive correlations were found between wounding time and RESVECH 2.0 scores before and after 4 weeks of therapy, as well as between wounding time and the magnitude of treatment effect. Discussion Manuka honey demonstrated greater efficacy than silver-based dressings in promoting the healing of diabetic foot ulcers, supporting its use as an effective alternative in clinical practice.