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This study aims to present the results and limitations of surgery for lower limb lipoedema and lymphedema in a resource-limited surgical setting. This was a cross-sectional, analytical, prospective, in-hospital study covering 15 years. We surgically treated 119 patients, including 18 with lipoedema (15.1%), 69 with stage 2 lymphedema (57.9%), and 32 with elephantiasis (26.9%). We included 81 women (68%) and 38 men (31.9%). The majority (57.7%) of patients with lymphedema were between 30 and 49 years of age. Plastic and excisional surgery was performed in 42.2% of patients with stage 2 lymphedema and in 87.5% with stage 3 (elephantiasis). Lipoedema surgery consisted primarily of liposuction (77.7%). No lymphatic network reconstruction was performed. Our results, at 2 years' post-surgery, were very satisfactory, with limb symmetry in 83.3% of patients operated on for lipoedema, in 84.2% of patients operated on for stage 2 lymphedema, and in 85% of patients operated on for elephantiasis. Surgery for lower limb lipoedema, lymphedema, and elephantiasis is feasible in a resource-limited setting, although challenges remain. The lack of lymphatic network reconstruction constitutes our limitations. Microsurgery is necessary for optimal results.