This session will review common presentations of both congenital and acquired limb deficiency, utilizing photos, X-rays, and videos of different presentations. The three faculty are directors of multidisciplinary amputee clinics in different parts of the country. The session will illustrate surgical considerations, with clinical cases to demonstrate when surgical consultation and management is necessary. Many patients require orthopedic intervention to provide the most functional limb possible, with or without a prosthesis. Finally, the presentation will review common pitfalls and pearls associated with the clinical management of these patients, such as initial clinical approach to the pediatric limb deficient patient, funding resources for sport-specific prostheses, and overuse syndromes in the adult congenital or acquired amputee. The didactic session is offered to confidently fill the gap in knowledge that is common when treating these rare but complex patients.