Objective: To investigate the effective methods for treatment of the lower leg vascular ulcers caused by mixed vascular etiologies. Methods: Endovascular therapy combined with minimally invasive surgery were performed in 22 patients with mixed vascular ulcers of the lower leg who were admitted from October 2008 to October 2011. The occluded segments of lower limb arteries of the patients were recanalized by balloon dilatation angioplasty and stents implantation, and their lower limb venous incompetences were treated with high ligation and stripping of the great saphenous vein as well as ligation of the perforator veins near the ulcers via small incision, respectively. Results: The ulcers in all of the patients were healed quickly and completely, and the average time of healing was 28 d. The follow-up period ranged from 6 to 28 months, and no recurrence was noted. Conclusion: Combination of endovascular treatment and minimally invasive surgery is effective for treatment of lower leg mixed vascular ulcers, and is recommend for use.