The article summarizes current views regarding venous leg ulcers. Venous ulcers are resource-demanding and affect 1% of the population. Superficial and/or deep venous insufficiency is to be found combined with perforator insufficiency in the ankle are. The pathogenesis is still open to debate, but is presumably related to capillary leakage, with seepage of blood components and ensuing lipodermatosclerosis, as well as to multiple capillary thromboses. Inappropriate leucocyte activation might also play a part. Compression stabilizes capillary function and thus is the cardinal treatment both regarding healing and prophylaxis. In 90% of cases there is no recurrence following superficial vein surgery, so long as the deep veins remain unaffected. In patients with deep venous insufficiency the risk of failure following-such surgery, perforator resection included, is related to the degree of insufficiency. If conventional treatment fails, reconstruction of the deep veins may be considered. Concomitant conditions such as arterial insufficiency and systemic diseases make treatment difficult, and the presence of Pseudomonas aeruginosa may in certain cases delay healing.