Peripheral arterial disease (PAD), defined as ankle-brachial index (ABI) < 0.9, affects 29% of people over 70 years or 50 to 69 years for smokers or those with diabetes.1 It often begins with symptoms of lower limb pain while walking (ie, claudication) and may remain underdiagnosed with limited or sporadic treatment until the patient experiences critical limb ischemia (CLI), defined as rest pain, tissue loss, or gangrene, typically with an ABI < 5.0.2 One in 4 patients with CLI dies during the first year following diagnosis.2 Treatment options are often limited for patients with PAD. Traditionally, those with PAD and a leg or foot ulcer receive endoscopic or open revascularization to restore arterial circulation,3 rendering the occluded vessel(s) patent for up to 70% of revascularized vessels for at least 5 years and salvaging 80% of revascularized limbs.4 Ongoing research will help determine what revascularization procedure(s) are appropriate for which patients and how to optimize their outcomes,5 as revascularization is not appropriate for all patients. For patients with a salvageable limb who were not candidates for revascularization, recent research showed aggressive conservative wound care healed 52% of full-thickness ulcers within 1 year if the ABI was < 0.7 in the affected limb6 or healed 67% of nonhealing ulcers in a mean of 4.7 months in patients with no pedal pulse if the affected limb ABI was < 0.9 and periulcer transcutaneous partial pressure of oxygen was > 30 mm Hg.3 However, 43% recurred in a mean of 10.7 months.7 Major amputations, more likely for those with an ABI < 0.5, have a grim prognosis. Among the elderly, 94% of major amputations are associated with PAD, with a 47% mortality within 2 years after amputation.8 Those with PAD requiring conservative management of their ulcers need better options to improve their chronic ulcer outcomes. This Evidence Corner explores recent reviews of topical vascular growth factors9 and electrical spinal cord stimulation10 aimed at improving chronic ulcer healing outcomes for patients with PAD before major amputation limits their options.