Heel decubitus ulcerations are relatively common occurrences that can be limb threatening. There are many options to treat these ulcerations, ranging from conservative wound care to serial debridement with flap reconstruction. However, not all patients are good candidates for major reconstructive surgery. In this case, we present a 46-year-old man who failed 3 months of conservative wound care after sustaining a heel decubitus ulcer because of immobilization from a motor vehicle accident. The ulceration was treated with sharp excision of the wound with calcaneal decorticalization and use of negative-pressure wound therapy to use the localized bone marrow within the wound bed. The patient went on to heal within 3 months of operative intervention and remains healed greater than 1 year postoperatively. This technique provided the ability to use localized bone marrow to assist in wound healing without the operative morbidity of a reconstructive procedure.