Purpose: This retrospective, observational database study aimed to report the national major limb amputation (MLA) rates and outcomes for Māori and non-Māori patients who underwent MLA in Aotearoa New Zealand (AoNZ). Methodology: A combined dataset using the National Minimum Dataset and the Australasian Vascular Audit database was used to include Māori and non-Māori patients who underwent MLA between the 1st of January 2010 and the 31st of December 2021 in AoNZ. Crude, age- and sex-standardised rates of MLA, survival post-procedure, and a comparison of 1-year outcomes were recorded. Results: There were 5,293 MLA in 4,242 patients. A total of 818 Māori patients (19%) underwent 1,089 MLA and 3424 non-Māori patients (80%) underwent 4,204 MLA. The 12-year overall age-standardised rate for Māori undergoing MLA was higher (14.33 per 100,000; non-Māori 5.21 per 100,000, p<0.001). Māori patients underwent a higher number of multiple MLA (Māori 29%, non-Māori 20%, p<0.001); and 73% of Māori patients had their index MLA under the age of 69 years, compared to 41% of non-Māori patients (p<0.001). Māori women underwent proportionately more MLA (42%) compared to non-Māori women (35%, p<0.001). The 1-year mortality rate after MLA was higher for Māori (33.6, 95%CI 30.2-37.1) compared to non-Māori (29, 95%CI 27.4-30.6). After adjustment for age, sex and comorbidities, there were shorter survival times post-MLA for Māori patients compared to non-Māori (HR 1.49,95%CI 1.34-1.66, p<0.001). Conclusion: There is significant inequity in the outcomes of MLA for Māori patients in AoNZ. Māori underwent more MLA, were younger, with a higher percentage of women, and shorter survival time post-MLA. This requires urgent attention with the implementation of equitable social and health policies and the introduction of healthcare delivery changes.