Objectives: This study aims to analyze patients with chronic lower limb lymphedema (LE) clinically, diagnostically and etiopathogenetically. Patients and methods: This single-center, retrospective national epidemiological study included a total of 558 patients (161 males, 397 females; median age: 43 years; range, 10 days to 94 years) with chronic lower limb LE who were treated in our department between January 2005 and January 2020. Primary and secondary LE were classified clinically by stage and severity and lymphoscintigraphically. Body mass index was calculated for the detection and classification of obesity. Results: A total of 72.5% of the patients had unilateral lower limb LE, while 27.5% had bilateral LE including lipolymphedema. The rate of the patients with obesity and pre-obesity was 71.2%. Primary LE patients (54.1%) were more common than those with secondary LE. The rates of clinical, clinical severity, and lymphoscintigraphic staging were 11.1%, 38%, and 28%, respectively for Stage I, 55.2%, 30.9%, and 42%, respectively for Stage II, and 33.7%, 31.1%, and 17%, respectively for Stage III. Complications were elephantiasis (13.3%), elephantiasis nostras verrucosa (3.0%), cellulitis (22.1%), erysipelas (2.3%), ulcer (2.6%), onychomycosis (27.4%), and lymphangiosarcoma (0.2%). Conclusion: Chronic LE is a challenging problem with poor quality of life, negative psychosocial effects, and disabling consequences, and it is of vital importance to recognize the disease in its early stages with awareness, diagnosis, and multidisciplinary approach.