Introduction Australia has 28% of its population living in regional, rural, and remote areas. High volume, regional vascular surgery units are essential in delivering care to these patients locally, alleviating their need to travel great distances to the metropolitan. Townsville University Hospital (TUH) is one such unit and the largest regional vascular unit in Australia, and services a large area including North and Western Queensland, with most of the work being in peripheral artery disease (PAD). This study reports the outcomes of revascularisation for PAD at our centre. Methods A retrospective cohort study was conducted with patients who underwent lower-limb revascularisation between January-2015 and July-2023 at Townsville University Hospital. Patients who presented with acute limb ischaemia or had previous revascularisation procedures were excluded. The clinical PAD severity was determined using the Rutherford classification at the initial presentation. Outcomes of the index revascularisation procedure were assessed, including major adverse limb events (MALE), major adverse cardiovascular events (MACE), major amputation, repeat revascularisation and all-cause mortality. MALE was defined as a composite of major amputation and repeat revascularisation, and MACE was defined as myocardial infarction, stroke, or cardiovascular mortality. Results 504 patients were included, with an average age of 71±10.3 years, and a proportion of 75.2% males. 34.3% of the patients presented with intermittent claudication, 8.0% with rest pain and 57.7% with tissue loss. 74.2% of revascularisation was endovascular, 23.8% open, and 2.0% hybrid. At 1- and 5- years post-procedure, the rate of MALE was 24.9% and 40.5%, with MACE at 15.5% and 29.1% respectively. Rate of major amputation was 4.6% and 9.1% at 1- and 5-years, with repeat revascularisation at 24.3% and 37.7%. The annual risk of mortality was 12.0%. Conclusion This study reports outcomes following revascularisation for PAD in a high-volume regional centre.