Near surface quantitative precipitation estimation (QPE) from weather radar measurements is an important task for feeding hydrological models, limiting the impact of severe rain events at the ground as well as aiding validation studies of satellite-based rain products. To date, several works have analyzed the performance of various QPE algorithms using actual and synthetic experiments, possibly trained by measurement of particle size distributions and electromagnetic models. Most of these studies support the use of dual polarization radar variables not only to ensure a good level of data quality but also as a direct input to rain estimation equations. One of the most important limiting factors in radar QPE accuracy is the vertical variability of particle size distribution, which affects all the acquired radar variables as well as estimated rain rates at different levels. This is particularly impactful in mountainous areas, where the sampled altitudes are likely several hundred meters above the surface. In this work, we analyze the impact of the vertical profile variations of rain precipitation on several dual polarization radar QPE algorithms when they are tested in a complex orography scenario. So far, in weather radar studies, more emphasis has been given to the extrapolation strategies that use the signature of the vertical profiles in terms of radar co-polar reflectivity. This may limit the use of the radar vertical profiles when dual polarization QPE algorithms are considered. In that case, all the radar variables used in the rain estimation process should be consistently extrapolated at the surface to try and maintain the correlations among them. To avoid facing such a complexity, especially with a view to operational implementation, we propose looking at the features of the vertical profile of rain (VPR), i.e., after performing the rain estimation. This procedure allows characterization of a single variable (i.e., rain) when dealing with vertical extrapolations. In this work, a definition of complex orography is also given, introducing a radar orography index to objectively quantify the degree of terrain complexity when dealing with radar QPE in heterogeneous environmental scenarios. Three case studies observed by the research C-band polarization agility Doppler radar named Polar 55C, managed by the Institute of Atmospheric Sciences and Climate (ISAC) at the National Research Council of Italy (CNR), were used to prove the concept of VPR. Our results indicate that the combined algorithm, which merges together differential phase shift (K dp ), single polarization reflectivity factor (Z hh ), and differential reflectivity (Z dr ), once accurately processed, in most cases performs better among those tested and those that make use of Z hh alone, K dp alone, and Z hh , and Z dr . Improvements greater than 25% are found for the total rain accumulations in terms of normalized bias when the VPR extrapolation is applied.