Purpose: Interhospital transfer (IHT) is essential for delivering specialist emergency vascular care in geographically dispersed healthcare systems. However, transfer-related delays are associated with increased morbidity, mortality, and healthcare costs. Real-world compliance with guideline-recommended transfer timeframes for vascular emergencies remains poorly characterised. The objective of this study is to compare timeliness of interhospital transfer for emergency vascular surgery in a regional hospital against predefined guideline-informed standards, and identify system-level contributors to delay. Methodology: A quality improvement audit of adult emergency vascular transfers was conducted within a regional hospital in NSW, Australia between 1st February 2025 and 31st October 2025. Transfer performance was benchmarked against diagnosis-specific standards derived from international vascular surgery guidelines. Compliance rates, delay duration, contributing factors, and associated costs were analysed. Results: Twenty-eight patients were included (median age 67 years; 57% male). Overall compliance with recommended transfer standards was 57.1%, with marked variation by diagnosis. Compliance was lowest for unstable chronic limb-threatening ischaemia (CLTI; 30%) and highest for stable stroke and chronic mesenteric ischaemia (100%). Bed availability and transport limitations were the most frequent contributors to delay. Total inpatient costs incurred while awaiting transfer exceeded AUD 104,000, with more than AUD 32,000 attributable to delays beyond recommended standards. Conclusions: This audit demonstrates significant variability in compliance with recommended interhospital transfer standards for emergency vascular conditions, particularly CLTI. These findings highlight actionable targets for system-level quality improvement to improve timeliness, outcomes, and resource utilisation.