Objective: To compare the energy expenditure and gait parameters of bilateral transtibial prostheses user with and without sleeve suspension. Materials and methods: Five (4 male, 1 female) bilateral transtibial, patellar tendon bearing supracondylar (PTB-SC) prostheses users, 2 years postamputation, having good residual limbs and muscle power, were recruited in the study. Instrumented gait analysis, physiological cost index (PCI), timed up and go test (TUG), cadence and subjective feedback questionnaire were recorded on day 1 (without sleeve suspension) and day 15 (with sleeve suspension). Sleeve suspension was added with the prostheses on day 1. Adequate gait training for two weeks was provided to the participants. Wilcoxon signed-rank test was performed in SPSS 25.0 to compare the data recorded on days 1 and 15. p value less than 0.05 was considered as significant. Results: The p values of various gait parameters walking speed, percentage of stance, swing, single limb support and normalized stride length, cadence and TUG test were found to be not significant while p value of step width and physiological cost index was considered significant. All the five subjects have reported comfort in ambulation after wearing sleeve suspension. Conclusion: The study reports the effect of PTB-SC sleeve suspension in improving gait parameters and energy expenditure in five bilateral below knee amputee. Statistically significant improvement was reported in the cost of energy consumption and step width, suggesting that good prosthetic fitment is essential. However, the change in other gait parameters such as walking speed, percentage of stance, swing, single limb support, and stride length remained within normative data range. There is a need to conduct the study in a larger cohort with bilateral amputation where the essential component in prosthesis fitment, like sleeve suspension, can be varied, which in turn can give better stability and comfort resulting in improvement in walking efficiency.