Transtibial amputations (TTA) drastically change patients' life styles and function. Ensuring cost-effective, functional outcomes begins with preoperative patient education and continues through the multiple evaluations and adjustments made by the rehabilitation team. Early basic prosthetic fitting and training should be initiated in most patients to promote recovery of func tional independence. With careful preoperative planning, meticu lous operative technique, and close postoperative follow-up, many of the potential complications of TTAs can be avoided, thus allowing the patient to return to preoperative independence using a prosthesis.