Vascular amputation represents a core indicator of vascular care. In addition to being a major vascular event similar to myocardial infarction or stroke, amputation practice characteristics reflect the history of affected patients and their environment. In this sense, research on amputations outreach to broader domains far from being limited to the healthcare sphere. This chapter aims to highlight vascular amputations as a quality indicator, cover the epidemiological aspects, demonstrate the determinants of the amputation risk and explore some of the most challenging clinical situations associated with limb loss. Aspects of healthcare policy against amputations are also addressed.