Purpose of Review <p>This review aims to synthesize current evidence on neuromuscular adaptations after transtibial amputation, with a focus on electromyographic patterns during gait. It addresses how muscle activation reorganizes in the absence of ankle function and how these changes influence rehabilitation strategies and prosthetic design.</p> Recent Findings <p>Recent studies consistently report earlier and prolonged activation of proximal muscle groups, increased coactivation around the knee during loading, and reduced or irregular tibialis anterior activity on the amputated limb. These findings highlight a redistribution of motor effort toward the hip and knee to compensate for the loss of distal control and sensory input. Advances in EMG-based prosthetic control and powered ankle technologies have renewed interest in understanding these activation patterns.</p> Summary <p>Neuromuscular adaptations after transtibial amputation reflect compensatory strategies that maintain stability but increase mechanical and metabolic demand. Clarifying these patterns may guide targeted rehabilitation and inform next-generation prosthetic development.</p>