Liposuction for late-stage lymphoedema remains a controversial technique. While it is clear that conservative therapies such as combined decongestive therapy (CDT) and controlled compression therapy (CCT) should be tried in the first instance, options for the treatment of late-stage lymphoedema that is not responding to treatment is not so clear. Liposuction has been used for many years to treat lipodystrophy. Some results have been far from optimal; however, improvements in technique, patient preparation and patient follow-up have led to a greater and a wider acceptance of liposuction as a treatment for lymphoedema. This paper outlines the benefits of using liposuction and presents the evidence to support its use.