Purpose This presentation assesses the outcomes of a new Plastic Surgery acute clinic (‘hot clinic’) introduced at Waikato Hospital to address the challenges faced by a geographically dispersed population requiring acute plastic surgical care. The clinic aimed to enhance patient safety, reduce overload on after-hours services, optimise operating theatre use, and minimize travel and hospital resource use. Methodology From 15 February 2024 to 15 January 2025, the hot clinic served 400 patients (423 bookings), covering a range of conditions, including closed fractures (53.25%), tendon/ligament/nerve injuries (14.5%), nailbed injuries (6.5%), open wounds (5.75%), post-op complications (5.25%), infections (5%), minor burns (4.75%), foreign bodies (3.5%), and other conditions (1.5%). The clinic used a "life or limb" triaging system during night shifts to prioritize urgent cases, allowing less urgent cases to be managed the following day. Results The implementation of the hot clinic improved workflow, reduced wait times, and decreased unnecessary Emergency Department attendances. It also led to reduced operating theatre time/costs and alleviated the burden on after-hours staff. Minor injury patients were able to rest, while complex cases were discussed with SMOs prior to assessment. The clinic allowed for better planning and accommodation of specific patient needs, such as for incarcerated individuals. Conclusion The hot clinic streamlined acute plastic surgery care, optimizing resource use and improving patient outcomes for a geographically dispersed community. Insights gained from the clinic’s implementation demonstrate the benefits of triaging, better use of medical staff, and enhanced care planning for diverse patient needs.