The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system has been validated to predict wound healing and limb salvage among patients with peripheral arterial disease (PAD). Our goal was to evaluate the predictive ability of WIfI in patients with PAD and tissue loss who were stratified to a conservative approach in a multidisciplinary limb preservation program. Veterans with PAD and tissue loss were prospectively enrolled into our Prevention of Amputation in Veterans Everywhere program. Limbs were stratified to a conservative approach based on perfusion evaluation and a validated pathway of care. Society for Vascular Surgery WIfI clinical stages (1-4) were assigned retrospectively. Rates of wound healing, wound recurrence, limb salvage, and survival were analyzed. Predictors of successful outcome were identified by univariate and subsequent multivariate analysis using Cox regression modeling. Between January 2006 and October 2017, 961 patients were prospectively enrolled in our Prevention of Amputation in Veterans Everywhere program. A total of 241 limbs with 281 wounds were stratified to the conservative approach. WIfI staging distribution included 19.1% stage I, 19.5% stage II, 39.8% stage III, and 21.6% stage IV wounds. Advanced wound interventions and minor amputations were performed on 40 limbs (16.6%) and 57 limbs (23.7%), respectively. The mean long-term follow-up was 41.4 ± 29.0 months. Complete wound healing was achieved in 189 limbs (78.4%) over a mean of 4.4 ± 4.1 months. Thirty-four limbs (14%) received delayed revascularization owing to conservative treatment failure. An additional 22 limbs (9%) achieved wound healing after delayed revascularization. At long-term follow-up, wound recurrence was 48% among the conservative cohort and 14% among the delayed revascularization group (P = .76). Overall limb salvage at long-term follow-up was 89.6%. When stratified by WIfI, there was no difference between groups for wound healing (P = .51), wound recurrence (P = .55), need for delayed revascularization (P = .34), or limb salvage (P = .58). In patients with PAD and tissue loss, a stratified approach achieved acceptable rates of wound healing and limb salvage, with a limited need for delayed revascularization. WIfI presentation did not further predict wound healing, wound recurrence, need for delayed revascularization, or limb salvage. The selection of patients with PAD and tissue loss for conservative therapy is achieved with our clinical pathway independent of WIfI classification.