Background and Aims Venous leg ulcers are severe complications of chronic venous insufficiency, characterized by high recurrence rates. They can result in prolonged hospitalization, increased financial burden on patients, reduced work capacity, and increased disability. Therefore, this study was performed to identify high-risk factors for the recurrence of venous leg ulcers, providing clinical evidence for effective prevention of ulcer recurrence.Methods The clinical data of patients with venous leg ulcers treated at Zhongshan Hospital, Xiamen University, from January 2021 to September 2022 were retrospectively analyzed. Univariate and multivariate logistic analyses were performed to identify high-risk factors for ulcer recurrence.Results A total of 182 patients with venous leg ulcers were included, all of whom received standardized dressing treatment in the chronic wound outpatient department. The recurrence rate of venous leg ulcers was 47.2%. Univariate analysis revealed a significant association between ulcer recurrence and the following factors: surgical intervention (χ²=19.206, P=0.000), use of elastic compression stocking (χ²=23.590, P=0.000), heavy physical activity (χ²=29.495, P=0.000), and heavy smoking (χ²=9.173, P=0.002). Multivariate Logistic analysis showed that age >60 years, BMI >24 kg/m², female gender, surgical intervention, use of elastic compression stocking, heavy physical activity, and heavy smoking were independent risk factors for the recurrence of venous leg ulcers (all P<0.05).Conclusion The recurrence rate of venous leg ulcers is high. Smoking cessation and reducing heavy physical labor are effective measures to reduce the recurrence of venous ulcers. Early surgical intervention in clinical practice can decrease ulcer recurrence in patients.