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Amputation in patients with complex regional pain syndrome (CRPS) remains controversial, with persistent ethical debate over removing a ‘viable’ limb and limited evidence to guide decision-making. This single-center retrospective observational study combined with a cross-sectional survey assessed long-term outcomes of amputation in 39 patients with severe, therapy-resistant CRPS. 1 In the long-term, amputation provided durable improvements in quality of life, functional ability, and pain, and nearly all patients reported satisfaction. Nonetheless, residual limb pain and phantom limb pain affected the majority of patients, and CRPS recurred in the stump in a small proportion. Taken together, the findings underscore that amputation should be regarded as a credible but extreme last-resort intervention, offered only in specialized centers with comprehensive CRPS expertise.