Objective To evaluate the therapeutic efifcacy of complex decongestive therapy in the treatment of elephantiasis of the lower extremities.Methods Seventeen patients with unilateral lower limb elephantiasis were included in the study (5 with primary lymphedema and 12 with secondary lymphedema). All patients were treated with one course (4 weeks) of complex decongestive therapy. Changes inextracellular fluid (ECF), BMI, circumferences, and skin properties including skin stiffness (SF), percent water content (PWC), and trans-epidermal water loss (TEWL) were measured before and after treatment. Results The elephantiasis-like appearance of the affected limb was greatly improved after treatment. The ECF, BMI,and circumferences were significantly decreased after treatment (P<0.001) with an average ECF of 2.97±1.82 L, BMI of 1.638±2.647 kg/m2, and circumference of 6.58±2.79 cm. The values of PWC, TEWL, and SFwere 50.5％±10.6％, 18.55±10.2 g/m2 h, and 0.161±0.176 N, respectively, before treatment and 36.05％±7％, 8.3±2.07 g/m2h, and 0.086±0.038 N, respectively, after treatment, there by showing signiifcant decreases (P<0.05). Conclusion Complex decongestive therapy is effective in the treatment of advanced stages of chronic lymphedema.