Lymphaticovenular anastomosis is well documented for its effectiveness in treating lower limb lymphedema. However, local anesthesia (LA) is not the usual choice of anesthesia. In this study, 14 patients having such operation done under LA were recruited to see how well they tolerated the operations. Visual analogue scale was used to grade both intraoperative and postoperative pain. It was shown that the mean intraoperative pain score was never greater than 1, in the scale from 0 to 10. The mean postoperative pain score was 1.6 on the first postoperative day and then dropped gradually. No complication of surgery was reported. In-depth preoperative counseling and complementary intraoperative measures were emphasized to make LA a possible choice of anesthesia.