Purpose: Measurement of tissue perfusion is key in management of peripheral arterial disease. Pedal acceleration time (PAT) is a non-invasive ultrasound technique, and can be used despite digital amputations, wounds, or non-compressible vessels. However, to what extent PAT changes with revascularisation, and if this differs by revascularisation technique is unclear. The aim of this study was to report and compare the change in PAT with open and endovascular revascularisation. Methodology: This was a prospective single-centre observational study. Patients with claudication or critical limb threatening ischaemia (CLTI) were recruited between 2020-2021. PAT measurements were obtained by trained sonographers, one day before and one day after revascularisation. Data was compared using Chi-Square or ANOVA and reported as % or median (IQR). Results: 142 patients/limbs underwent PAT measurement (107 endovascular, 22 open, 13 hybrid [excluded]). The median age was 72yrs (70% male; 65% diabetic, 22% ESRF). Most patients had CLTI (15% rest pain, 80% tissue loss). Median pre-revascularisation PAT was 245.2±71.8ms, which reduced significantly post-revascularisation to 125.1±45.4ms (P<0.001). Open surgery resulted in a greater decrease in PAT compared to endovascular (136ms [IQR 52-197.5] vs 96ms [IQR 48-96], P<0.001). Diabetic patients had a smaller change in PAT with revascularisation (48.7ms less, P<0.001). Conclusion: This study shows that PAT responds appropriately to revascularisation. Open revascularisation resulted in a larger improvement in PAT compared to endovascular revascularisation. Diabetes reduced the average improvement in PAT. Future studies should seek to validate these findings in larger cohorts and assess the impact of disease severity on PAT.