Treatment of lymphedema requires integrated and extensive management in several steps. Surgical treatment follows conservative therapies when adequate results were not obtained. It is individually planned and requires long-term postoperative rehabilitation. Surgical procedures are classified as physiological or excisional. Physiological procedures aim to improve lymphatic drainage, whereas excisional techniques are used to remove the affected tissues. Early results of surgical treatment are usually satisfactory and meet the expectations of the patients. However, treatment requires long-term postoperative care tailored to disease severity and coordinated along with continued conservative management.