Chronic leg ulcers can be defined as a breach in the epithelial integrity of the skin which occurs between the ankle and the knee for over six weeks. Although a large proportion (comprising arterial, venous, pressure and diabetic ulcers) can be treated conservatively, some ulcers would benefit from early surgical input and intervention. This article provides guidance on when such patients should be referred for surgical opinion and what surgical options are available. Finally, amputation and prosthetic options available will be considered.