Although severe lower extremity peripheral arterial disease affects more than 12 million people in the United State secular trends in the risk of amputation remain unexplored in recent years. Using national billing and survey data sets from the Centers for Medicare and Medicaid Services and the Behavioral Risk Factor Surveillance System, we examined trends in lower extremity amputation rates, diagnostic and therapeutic vascular procedures, and the use of preventive measures aimed at limiting the use of amputation procedures in the United States between 1996 and 2011.