Abstract The concept of the “Woundosome” has emerged as a novel framework to better understand and manage chronic limb-threatening ischemia (CLTI). By integrating anatomical, physiological, and wound-healing perspectives, the Woundosome provides a more comprehensive approach to procedural planning and outcome assessment. In this discussion, we will explore how the Woundosome model can influence therapeutic strategies, optimize revascularization choices, and improve limb salvage rates. To illustrate its practical implications, we will present selected clinical cases highlighting its role in guiding decision-making and predicting procedural outcomes in patients with CLTI.