Background Heel pressure injuries (HPIs) are the second most common type of pressure ulcers. Despite their frequency, however, HPIs are poorly understood and remain difficult to treat. Aim To describe the rationale behind the need for a structured evidence-based approach to assessing and treating HPIs in adult, paediatrics and diabetic populations. Methods Several clinical questions were identified and incorporated into six domains to provide a framework for defining evidence-based recommendations for HPI assessment and treatment. This framework focuses on three populations: adults, paediatric patients, and patients with diabetes. Conclusion This article describes strategies, rationales, and efforts needed to generate a series of evidence-based recommendations in our six identified domains and three patient populations. The Italian Nurses' Association for Wound Care (AISLeC) has organized a Consensus Conference on the assessment and management of HPIs to present these results and recommendations in November 2018.