Background: Surgical site adverse events (SSAEs) following vascular reconstructive procedures, particularly in the groin area, present significant challenges, impacting patient outcomes, and healthcare costs. We conducted a randomized controlled trial to assess the efficacy of closed incisional Negative Pressure Wound Therapy (CINPT) in reducing groin wound complications compared with standard dressings. Patients and Methods: Patients undergoing lower limb vascular procedures involving groin incisions were enrolled and randomized into two groups: CINPT or standard dressings. Baseline characteristics were recorded, and wound assessments were conducted at 5, 10-14, and 30 days postoperatively, utilizing the Szilagyi classification for wound grading. The primary outcome was the occurrence of any groin wound complication within 30 days. Results: Among 62 patients (70 groins), CINPT significantly reduced the incidence of groin wound complications compared with standard dressings (5.26% vs. 28.13%, P=0.022). Revision surgeries were less frequent in the CINPT group, though not statistically significant. CINPT was associated with a shorter hospital stay (5.86 +/- 2.49 days vs. 8.74 +/- 5.90 days, P=0.0096). Subgroup analysis revealed significant benefits of CINPT in patients over 50 years, diabetics, smokers, and those with elevated inflammatory markers. Conclusion: CINPT offers a promising strategy for mitigating groin wound complications following vascular procedures, enhancing patient outcomes, and potentially reducing healthcare costs.