Lymphoedema can present with an array of distressing symptoms, which can pose significant management dilemmas. First-line treatment involves established therapies including elevation, manual drainage and compression hosiery. However, failure of these medical strategies can occasionally necessitate surgical intervention to alleviate symptoms. This case highlights the role of surgical debulking in the management of an intractable case of lower limb lymphoedema with symptoms so severe that the patient requested amputation of her left lower extremity. This report also describes other surgical modalities in the management of this debilitating condition.