The earliest evidence of surgical amputation of a limb dates back about 31,000 years ago, whereby a young adult from the island of Borneo had the distal third of their left lower leg amputated. Barber surgeons attempted to improve this procedure in the sixteenth century, primarily through decreased operative times and improved surgical instruments. On average, barber surgeons performed leg amputations in 3-4 minutes. Dr Robert Liston famously performed amputations of the leg in less than a minute, with his fasted amputation taking only 28 seconds. This earned him the title of the “fastest knife in the west end”. Some of the early surgical developments included antisepsis (Lister), vessel ligatures (Paré), and the application of a tourniquet (Morell). The English surgeon Dr Lowdham was the first to describe the “flap amputation”, which involved the use of a soft-tissue flap for a tension-free closure over the bone. The introduction of anaesthesia in the 19th century revolutionised surgery, and this allowed for further developments in surgical approaches. Significant advancements in post-operative management have also contributed to reduced complication rates and improved functional outcomes. Such outcomes have been aided by advancements in prostheses, which have evolved from modified crutches to highly functional prostheses with elevated sensory and motor control. The history of limb amputations demonstrates the intersection of necessity, innovation, and compassion, thus transforming it into a procedure that restores function and improves quality of life.