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35 patients (16 upper extremity/19 lower extremity) with refractory lymphedema were enrolled on a longitudinal study using the ReidSleeve in combination with the BioCompression/Optiflow system. The primary objective of this study was to evaluate the effectiveness of this combined modality therapy. Patients wore the ReidSleeve at night and used the BioCompression pump with the ReidSleeve Optiflow insert for 2 sessions of 60 minutes during the day with class II compression stocking for the remainder of the day. Among patients with upper extremity edema, the reduction in lymphedema was 24.7, 53.8 and 80.2% at 4, 12 and 28 weeks. Linear regression analysis demonstrates a highly significant (p<0.001) reduction in arm edema during the course of treatment. A plateau phase occurred between weeks 4 and 8 weeks. Among patients with lymphedema edema of the lower extremity, the average reduction was 296, 646, 607, 484, 305, and 884 ml at 1, 2, 4, 8, 12 and 16 weeks respectively. These patients demonstrated marked reductions in lymphedema during the first 2 to 4 weeks followed by a period of relatively stable lymphedema until week 12 with a further decrease in average volume of lymphedema of 14496 cubic centimeters by week 16. Linear regression analysis demonstrates a significant (p<0.001) decrease in leg edema. The ReidSleeve used in combination with the BioCompression/Optiflow system provides effective management for upper and lower extremity lymphedema.