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Background: Approximately 150,000 patients undergo a lower extremity amputation per year. Following lower extremity amputation, preservation of the contralateral lower extremity is of utmost importance. The purpose of this case report is to highlight the role of physical therapy in comprehensively rehabilitating patients with complications to the lower extremity contralateral to the prosthetic limb and discuss the ethical dilemma between patient autonomy and physical therapist responsibility. Case Description: The patient was a 72-year-old Caucasian male who was admitted to a Midwestern major medical center for class IV cellulitis of his left lower extremity, characterized by sepsis and a National Early Warning Score (NEWS) of > 4. Two years prior, CM elected to have a below knee amputation (BKA) on his right lower extremity secondary to non-healing ulcers from peripheral vascular disease. Following the onset of left lower extremity cellulitis, CM was unable to take care of his family farm secondary to enhanced pain and impaired functional mobility, gait stability, strength, safety, and muscular endurance. Intervention: An interdisciplinary approach was necessary to treat the root cause as well as psychological and spiritual stresses. Physical therapy focused on advancing functional mobility as the patient allowed including: bed and chair exercises, stand pivot transfers, sit to stand transfers, ambulation with walker, ambulation with single axillary crutch, and negotiating challenging environments. Outcome: The primary measures used to assess this patient were assistance level, Dynamic Gait Index, distance walked without resting, gait steadiness, and ability to negotiate challenging environments. Discussion: This case report highlights a positive outcome of a patient status post BKA with complications to his contralateral lower extremity following a progressive rehabilitation program in order to discharge safely to his family farmhouse.