Objective. To estimate the effectiveness of the application of sulodexide for the combined treatment of the patients presenting with trophic ulcers on the lower extremities of venous etiology. Material and methods. This study included 86 patients of either sex at the age from 26 to 83 years presenting with Class C6 chronic venous diseases. The patients of group 1 (n=42) received sulodexide during 50 days in addition to the conventional treatment. Those of group 2 (n=44) were treated according to the standard procedures alone. All the patients passed through: ultrasonic dopplerography and angiographic scanning, planimetry of trophic ulcers by the standard contact technique, microbiological and cytological studies of the dynamics of microbial spectrum, the level of contamination and regenerative processes in tissues. Results. Cleansing the surface, the appearance of granulation, and the onset of epithelialization in the patients of groups 1 and 2 were documented on days 6,2±1,2 and 9,8±1,4 (p=0,059); 9,8±0,8 and 13,4±1,6 (p=0,048); 15,9±2,1 and 23,6±1,2 (p=0,003), respectively. One month after the start of the treatment epithelialization was achieved in 16 (38,09%) patients of group 1 and in 9 (20,45%) ones in group 2 (р=0,118). Two months after the onset of the study,) epithelialization of venous ulcers was documented in 40 (96,19%) and 23 (52,27%) patients of groups 1 and 2 respectively(p=0,001). The time of complete epithelization of trophic ulcers in the patients of groups 1 and 2I was amounted to 48,6±0,6 and 74,2±0,2 days respectively (p=0,001). On days 10 and 20 of the treatment, the amount of microbial flora decreased in comparison with the initial growth rate. This reduction was especially pronounced in the patients of group 1. The results of the measurements of the level of microbial contamination of trophic ulcer discharge on days 10 and 20 of the treatment suggested its reduction that was especially well apparent on day 20 in the patients of group 1. Conclusion. The treatment with sulodexide is an effective and pathogenetically justified mode of managing the patients presenting with trophic ulcers of venous etiology.