To refer or not to refer is the question? Many of us have witnessed the awful impact of lower limb ulceration on people’s physical, social and psychological wellbeing. Most lower limb wounds that are slow to heal will be due to either venous or arterial insufficiency and will benefit from referral or advice and guidance from vascular services. By addressing underlying vascular issues, we can reduce the risk of lower limb loss, aid healing and prevent reccurrence of lower limb ulceration. Therefore, it is essential that we seek advice and guidance early and refer people into vascular services with all relevant clinical information so that, so that vascular colleagues are able to appropriately prioritise care.