A 67-year-old-woman presented with an intractable vein stasis ulcer on her lateral malleolus. The ulcer was initially treated using compression therapy. However, as she was suffering from intense pain, we opted to discontinue the compression therapy and simultaneously performed varicose vein surgery. We then started local treatment using polyhexanide betaine gel. Seventeen weeks after the operation, the ulcer had completely healed and there has been no recurrence over the last 20 months. Local treatment using polyhexanide betaine gel in conjunction with varicose vein surgery can be an effective treatment option for venous ulcers.