Aims: To evaluate the effect of bespoke compression hosiery (Advanced Therapeutic Materials Ltd) on patients who require compression therapy for leg ulceration. Methods: An evaluation of clinical outcomes in 16 patients, eight with confirmed venous disease and eight with healed ulceration for whom standard hosiery does not fit, stay in place or is not tolerated. The patients were scanned using a hand-held 3D imaging unit to determine the size and shape of their lower limb. The generation of a 3D image and a pressure map is used to produce bespoke hosiery, and to calculate limb volume. Results: All of the patients were able to wear their hosiery and over the course of the study eight patients ulcers improved and eight patients’ legs were maintained. Conclusion: Bespoke compression hosiery exerts sufficient interface pressure and may be used in the prevention and treatment of chronic venous insufficiency. Declaration of interest: No sponsorship has been provided for this study. Advanced Therapeutic Materials Ltd provided the scanning machine and personnel to scan the patients’ legs. They also provided the bespoke hosiery.