Background <p>While telemedicine is gaining traction for patients managing peripheral vascular disease, more investigation is warranted to truly understand its impact. This study set out to pinpoint the shortcomings of current telemedicine applications for individuals with these conditions.</p> Methods <p>We conducted a longitudinal observational study, analyzing data from 1,096 peripheral vascular disease patients who participated in telemedicine between August 2013 and August 2023. Key metrics included consultation duration, diagnosis, physician involvement, post-treatment outcomes, and patient satisfaction.</p> Results <p>Telemedicine adoption has risen consistently over the years, alongside an upward trend in two-way referral rates. From 2013 to 2023: the number of patients referred for further diagnostics and treatment at outpatient clinics shot up from 6.38% to 12.50%; those sent to the emergency department doubled from 8.51% to 25.00%; and those admitted to the inpatient department increased from 4.26% to 13.69%. No statistically significant variation was found in outcomes across different vascular conditions. However, patient satisfaction differed notably based on physician seniority. Chief physicians received significantly higher “very satisfied” ratings (89.80%) compared to attending physicians (z= -2.874, <i>p</i> = 0.004), while dissatisfaction ratings also showed meaningful divergence (z= -2.763, <i>p</i> = 0.006). There were 89.80% of patients expressing great satisfaction with the chief physician’s consultation.</p> Conclusions <p>As telemedicine gains traction, referral rates continue to climb, underscoring its expanding role in patient care. The involvement of senior specialists proves critical not only for boosting referral efficiency but also for enhancing patient satisfaction. Leadership engagement remains a key driver in optimizing these outcomes.</p>