This retrospective study investigated complications following major lower limb amputations (MLLAs) in 136 individuals in Saudi Arabia who had not yet been fitted with a prosthesis. The most common pre-prosthetic complications were muscle weakness (55.1%) and edema (52.9%), with infection being the least reported (5.1%). Significant associations were found between age and etiology, assistive device use, and complications, as well as between time since amputation and complications. The findings highlight a gap in early post-amputation care and emphasize the need for national strategies to promote timely rehabilitation and prosthetic evaluation to prevent complications and improve patient outcomes.