This retrospective study was conducted to examine the indwelling time and complication rate in routine replacement versus clinically indicated replacement of peripheral intravenous catheters in the adult intensive care population. A total of 73 patients with 286 peripheral intravenous catheters were included in the routine replacement group; 64 patients with 296 peripheral intravenous catheters were included in the clinically indicated replacement group. The device days for the clinically indicated replacement group was significantly longer than the RR group (CI: 4.2, RR: 3.35, p < .00001). Chi square test showed no significant differences in complication rates between cohorts (p = 0.057, z = -1.91, RR 1.32, %RR 32, CI 1.00-1.76). The results suggest that clinically indicated replacement and routine replacement of peripheral intravenous catheters have equivalent incidence of complications. Adoption of clinically indicated replacement may spare patients from unwarranted pain, decrease nursing workload and increase cost savings for hospitals.