OBJECTIVE: To provide a perspective on the recent trends in the etiologies and levels of lower limb amputations in Korea. METHOD: Medical records of 284 patients discharged from Seoul National University Hospital between 1990 and 1999 who had amputation related procedure codes were reviewed. Data were used to calculate ratios of congenital anomaly, trauma related, tumor related, diabetes related, and vascular insufficiency related amputations, and ratios of each level of amputations. Trends over time were examined by comparing data from 1990 to 1994 with those from 1995 to 1999 using chi square tests. RESULTS: Dysvascular amputations accounts for 53.5% of lower limb loss in recent 10 years, and tumor (18.9%), congenital anomaly (14.5%), and trauma (6.1%) ranked the next common etiologies. The proportion of dysvascular amputations since 1995 was found to be significantly greater than the ratio before 1995 (p<0.05), and the ratio of amputations secondary to congenital anomaly was lower (p<0.05). There was no significant change in the level of amputations. CONCLUSION: Over recent 10 years, the risk of amputation secondary to dysvascular conditions has been increased, which warrants further investigations and efforts to improve our management of amputees.