Severe burns may necessitate limb amputations due to complications like infection, necrosis, and compromised vascular supply. This retrospective audit examines the contributing factors to limb amputations in burn patients at Chelmsford Hospital’s Plastic Surgery and Burns Department over seven years. The study found that underlying comorbidities such as sepsis, intravenous drug abuse (IVDA), and peripheral vascular disease (PVD) were significant contributors to amputation risk, rather than burn severity alone. Major amputations were often due to severe sepsis and PVD, while minor amputations resulted from burn-associated ischemia and necrosis. The psychological impact of amputation, including PTSD and depression, emphasizes the need for integrated psychosocial support. The audit also recommends earlier vascular surgical input and standardized multidisciplinary team (MDT) assessments to improve outcomes and reduce avoidable amputations.