Purpose Pedal acceleration time (PAT) is a novel non-invasive perfusion measurement that may have usefulness in peripheral artery disease (PAD) and diabetic foot disease (DFD). The objective was to assess the change in PAT post-revascularisation, and the association of PAT with wound healing and major limb amputation (MLA). Methods This observational prospective study reviewed all patients that underwent PAT and presented with intermittent claudication, chronic-limb threatening ischaemia and DFD at a single tertiary center from 1/7/2019 to 30/6/2022.PAT was defined as the time (ms) from the onset of systole to the peak of systole in the mid-artery. Pre and post-revascularisation PAT were taken, and patients were followed until June 2023 with the outcomes of wound healing, MLA and death collected. A sub-analysis was performed separately for patients with diabetes. Wilcoxon signed-rank test was used to determine the change in PAT, and Mann-Whitney U test to compare to dichotomous groups. Results Overall, 389 patients (455 limbs) were included, with a follow up of 1.74 years (interquartile range (IQR) 1.36-2.27). Post-revascularisation the median PAT decreased by 91 ms (IQR 44-165.5; p<0.001). The change was smaller for patients with diabetes (76 ms, IQR 36–141.5, p<0.001) compared to no diabetes (151 ms, IQR 73.5-195.3,p<0.001). Patients that achieved wound healing had a lower final median PAT (healed: 104 ms, IQR 88.5-124 vs. not healed: 138 ms, IQR 100-186; p<0.001). Patients that underwent MLA had a median final PAT of 150.5 ms (IQR 110.3-198) compared to those that didn’t undergo a MLA 110 ms (IQR 89-147, p<0.001). Conclusion PAT responds to lower limb revascularisation, and the post-revascularisation PAT appears to be associated with wound healing and MLA. PAT may be a valuable tool to assist with assessing the success of revascularisation and the potential for wound healing in patients with and without diabetes.