Leg ulcers caused by chronic venous insufficiency have long been a concern of patients and physicians alike, because of its high prevalence and the difficulties encountered in establishing satisfactory healing. Venous ulceration is the end stage of chronic venous insufficiency and up to recently little progress in the surgical treatment of this disease has been made. Last decade, however, new less invasive surgical approaches have been published with promising results concerning ulcer healing and postoperative morbidity.