Surgical options for treating lymphedema have expanded in recent years. For many years the only treatment options were conservative nonsurgical therapies and excisional surgeries. Advances in microsurgery have made it possible to reconstruct lymphatic function. Reconstructive surgical options include lymphaticovenular bypass, lymphaticolymphatic bypass, and vascularized lymph node transfer. Currently, there is no consensus on how or when to surgically treat lymphedema, and more studies are needed to evaluate the efficacy and risks of each of these techniques.