Background: Leg ulcers in deep venous insufficiency, especially the postthrombotic type, are often resistant to therapy. Objective: The purpose of this study was to evaluate short-term and long-term effects of shave therapy in persistent or recurrent venous ulcers. Methods: From January 1994 to October 1997, 80 patients with 105 chronic leg ulcers were treated by shave therapy. This method involved removing ulcers together with the surrounding lipodermatosclerosis and covering the wounds with meshed split-skin graft. Fifty-nine patients with 76 ulcers were examined after 3 months for assessment of short-term results. The first 18 patients with 26 ulcers from the years 1994 and 1995 were evaluated for long-term results. Results: The short-term healing rate after 3 months in 59 patients was 79%. Of 8 patients from 1995 (follow-up period, 1 year and 8 months), 7 patients had complete healing and 1 patient had a small ulcer. Of 10 patients from 1994 (average follow-up period, 2 years and 8 months), 8 patients had complete healing and 2 patients showed small superficial ulcerations within the transplanted areas. From these results, a long-term healing rate of 88% was calculated in 18 patients. Two of the 3 patients with recurrences had stopped compression therapy after good short-term results. Conclusion: For patients with recalcitrant leg ulcers in deep venous insufficiency and/or postthrombosis, shave therapy is a simple, quick, and effective surgical method with favorable short-term and long-term results. (J Am Acad Dermatol 1998;39:232-8.)