Varicose veins are twisted and enlarged veins that are commonly found in the legs. When veins become varicose, the valves stop working properly, allowing blood to flow backwards and the veins to engorge. Chronic wound develops on the skin due to poor circulation, often associated with varicose veins where impaired blood flow leads to persistent ulceration. A case of 45-year-old male affected with chronic non-healing ulcer precisely at the medial aspect of the left lower limb with deep vein thrombosis. He was brought with a foul-smelling ulcer with purulent discharge which was not healed despite using the allopathic treatment for months. Even with treatment, it got worsened so the fear of surgical necessity enforced him to take Siddha consultation at our clinical facility in Siddha Clinical Research Institute, Thiruvananthapuram. After leech application along with Siddha medicines for two months the wound got healed. There are no adverse effects reported during the leech application. It is concluded that leech therapy with Siddha medicines may be an effective management for chronic varicose ulcers.