The Authors present their 50 years of Research and Experience on the Surgical Therapy of Lymphatic and Chylous Disorders with Related Syndromes. The development of surgical techniques to restore lymphatic flow offers a treatment that targets more than symptomatic relief, but above all, functional repair of the underlying problem of lymph or chylous stasis. Lymphatic Microsurgery has a basic role in the treatment of these disorders and of their related complications. New techniques have also emerged for the combined treatment of advanced stages of chronic peripheral lymphoedemas, where there are significant fibrotic adipose tissue deposits with disease progression, which contribute to residual lymph stasis and increased risk of infection. The original technique of Fibro-Lipo-Lymph-Aspiration using a Lymph Vessel Sparing Procedure (FLLA-LVSP) was developed by the Authors to improve chronic swelling of patients with advanced lymphoedema. In the diagnostic protocol and for the follow-up, Lymphoscintigraphy of superficial and deep systems represents, in the experience of the Authors, a fundamental study for the surgical indication, including the Whole Body Lymphoscintigraphy to detect gravitational and/or chylous systemic disorders. From the diagnostic and prognostic point of view, histopathologic staging by immuno-histochemistry is of basic importance.