Introduction: Lower limb amputations due to diabetes are devastating. The world rate is 5,28 per 1.000 diabetic patients. The rates of lower limb amputation in 3 years and the regional differences in diabetic patients of the contributory healthcare system in Colombia are identified. Methodology: A retrospective cohort study of diabetic patients, of the contributory healthcare system in Colombia from 2013 to 2017, with 3-year follow-up. Results: There were 601138 diabetic patients, 45.14% men and 54.86% women. 2973 amputees, 61.45% men and 38.55% women. Amputation rates: Men 6.73 (95% CI [6.42 - 7.04]), women 3.47 (95% CI [3.27 - 3.67]), 80 years or older 7.67 (95% CI [6.90 - 8.45]), 60 to 79 years 6.26 (95% CI [5.96 - 6.60]), 40 to 59 years 3.26 (95% CI [3.02 - 3.50]), under 40 years 0.89 (95% CI [0.57 - 1.21]), Charlson’ index 6 or higher 13.14 (95% CI [10.57 - 15.70]), 4 to 5 points 14.15 (95% CI [12.77 - 15.54]), 3 o less points 4,38 (95% CI [4.20 - 4.55]), adjusted for regions: Atlantic 5.90, Bogota DC 3.99, Central 4.24, Eastern 5.64, Pacific 5.71, Other Departments 12.19. Conclusions: Lower limb amputation rates are higher in the most remote areas of the country, with difficulty in access to the healthcare system and advanced limb salvage management. Mainly men are amputated, older than 60 years and with a higher Charlson’s comorbidity index.