Lipoedema only affects women; it persists lifelong and and tends to progress gradually or intermittendly. Though we do not understand many aspects of this disease, we are able to offer very effective conservative and surgical treatment modalities; they improve shape and symptoms and enable the patients to live a fairly normal life again. Combined decongestive therapy (manual lymphatic drainage, compression garments) is able to minimize oedema. Tumescent liposuction is used for reducing the increased volume of fatty tissue. It can be applied in stage I, in stage II and – depending from the patients weight, the amount of subcutaneous tissue and the elasticity of the skin – in stage III. Liposuction causes a correction of shape with a decrease in the circumference of hips, legs and arms, resulting in a normalization of body proportions. In addition there is a significant and long lasting improvement – sometimes a complete disappearance of spontaneous pain and pain due to pressure. This causes an improvement of mobility, cosmetic impairment and a marked increase of quality of life. Though many aspects of this treatment – especial the reduction of pain - are not well understood, the impressive long-term benefits of liposuction in patients with lipoedema are well documented. Up till now liposuction is the best treatment option we have in patients with progressive disease. Though the results demonstrate a long lasting positive effect, it should be pointed out that surgery cannot cure lipoedema completely in all patients; in case of a (reduced) persisting oedema formation, decongestive therapy and compression is still necessary in many patients, although at longer intervals and to a much lower degree.