ABSTRACT: Traditional suction suspension is well documented for fitting amputees with transfemoral amputation. Volume fluctuation and shape change in the transfemoral residual limb can impact the quality of linkage obtained with this type of suspension. Poor linkage can have a negative impact on activity level, confidence, and overall ability of the transfemoral amputee to use the prosthesis. The purpose of this case report was to document the change in the ability to ambulate for persons with transfemoral amputation as they transition from a prosthesis with traditional suction to one with shuttle lock suspension supplemented with suction (passive vacuum [PV]). A 59-year-old male subject with a unilateral transfemoral amputation experienced a decline in participation activity level and decreased confidence while using a prosthesis with suction suspension and ischial containment (IC) socket design. The Amputee Mobility Predictor with prosthesis (AMPpro) was administered while he used the suction-only prosthesis and after 5, 9, and 12 months with a prosthesis featuring shuttle lock suspension combined with PV along with a total surface bearing (TSB) socket interface (SI). His AMPpro scores increased 5 points in the first 5 months with the PV prosthesis and improved slightly in the final 7 months of testing. Performance in reaching, transfers, and static balance tasks improved, allowing the subject to transition from an activity level K2 to activity level K3. The subject’s improved capability can likely be attributed to the combination of the prosthesis with the PV SI along with physical therapy.