Ambroise Paré (1510-1590), the French barber, is widely seen as the father of modern limb amputation surgery – but much of what distinguished his surgical technique is deeply rooted in classical practice. Herein, we discuss the origins of the principles of modern amputation. The first successful surgical amputation was likely performed in Borneo in 31000BCE however the earliest documentation of amputation is from 15th century BCE Egypt. Though major amputation was performed, the cultural significance of limb-loss directed emphasis toward conservative cares (eg grease and honey-based dressings). Such measures were also embraced by Hippocrates of Kos (~460BCE), who taught that drying gangrene to facilitate auto-amputation is preferred to iatrogenic amputation. Where amputation was offered, disarticulation was preferred to simplify wound management. Though wounds were left open for infection control and haemostasis provided by hot iron thermal cautery, outcomes were poor. In the 1st century CE, Roman surgeon Celsus re-imagined major amputation, preferring osteotomy given superior healing and lower infection risk, employing systematic vascular ligation with thread for haemostasis. A skin flap for bone coverage was fashioned, but wounds were left open and packed with wine-soaked cloth. Preoperative limb cooling was adeptly employed for both analgesia and vasoconstrictive haemostasis. Aided by advances in herbal anaesthesia (eg mandrake, opium), Albucasis of Cordoba revived these principles in 1013 CE (following the middle-ages surgical dormancy). He formalised techniques of amputation, used both proximal and distal haemostatic tourniquets and mastered the double-suture closure. His focus on postoperative dressings reduced infection and promoted both healing and functionality. The performance of limb amputation has imbued humanity with insights into medicine and surgery, and by studying its origin, we see the principles of modern clinical practice flourish.