Purpose: Major limb amputations (MLA) as a result of peripheral arterial disease (PAD) and/or diabetic foot disease (DFD), has major physical, psychological, functional, and financial ramifications. Decision making when considering a major limb amputation is complex and requires an individualised approach. Furthermore, there is an increasing prevalence of PAD and DFD. The aim of this study was to evaluate the indications for and outcomes from MLA in the New Zealand context. Methodology: This was a retrospective single-centre study of patients who had a MLA between Jan 2022-Dec 2024 for PAD and/or DFD. Baseline demographics, indication, data on prior revascularisation attempts, and outcome data were collected. The primary outcome was mortality. Secondary outcomes were length of stay and reintervention. Data is expressed as mean±SD or %. Results: Overall there were 154 major limb amputations (64±13 years, 68% male), of which 48% were below-knee, 49% were above-knee, and 3% were through-knee. 48% of patients were New Zealand European and 42% were Māori. 41% of patients domiciled from the most socioeconomically deprived quintile of New Zealand. The indication for operation was infection in 62% and ischaemia in 61% of patients. 25% of patients had a revascularisation attempt during the current admission (76% endovascular), while 45% had a revascularisation attempt on a previous admission (65% endovascular). 30-day mortality was 8%, and 1-year mortality was 21%. The total average length of stay was 18±18 days. The reintervention rate was 17%. Conclusion: This study affirms that major limb amputations are a common procedure and remain a significant cause of morbidity and mortality. There is a disproportionate impact on Māori (18% of New Zealand) and those from socioeconomically deprived backgrounds. Similar proportions of patients undergo major limb amputations for infection or ischaemia. This data may help benchmark current standards for future work to improve patient outcomes.