Thanks for asking! We strongly recommend the use of a low-profile foundation. They help distribute weight to extend the life of the slats and frame! For this bed, from where the slats are at the base of the side rail to the top of it is 6" so a low-profile foundation would sit in there nicely. Visually, it would depend on how you want the bed to look; adding a foundation gives more height to the mattress and covers more of the headboard.