To assess the efficacy of compression therapy alone, we report herein the long-term results of leg lymphedema using elastic stockings. Between January 1965 and March 1993, 41 primary lymphedema and 74 secondary lymphedema of the lower extremities have been treated at our hospital. Ten patients had recurrence of cancer, and 5 patients had surgical therapy. The remaining 100 patients were analyzed for the clinical results following treatment with elastic stockings. During the follow-up period of 5 +/- 0.2 years, 3 of 39 limbs (8% or 30 patients) with primary lymphedema wearing elastic stockings experienced enlargement of limb circumference and 36 limbs (92% or 27 patients) showed decrease or no change. Without elastic stockings, 1 out of 13 limbs (8% or 8 patients) with primary lymphedema showed worsening of their symptoms. In contrast, only 1 of 61 limbs (1.7%) in 46 patients with secondary lymphedema who wore elastic stockings showed deterioration of their symptoms. Although elastic stockings did not influence the incidence of the lymphangitis, their effect in maintaining limb circumference was apparent in all the patients with inflammation caused by secondary lymphedema. Among 20 patients with secondary lymphedema who had recurrent lymphangitis, only 1 out of 19 limbs (5%) in 16 patients experienced deterioration of the symptom with the use of elastic stockings while 1 out of 4 limbs (25%) in 4 patients showed improvement or no change without elastic stockings. Our data demonstrate that compression stockings are associated with long-term maintenance of reduced limb circumference, especially in secondary lymphedema regardless of the association with recurrent lymphangitis.