Lymphedema is a common condition frequently seen in cancer patients who have had lymph node dissection +/− radiation treatment. Traditional management is mainly non‐surgical and unsatisfactory. Surgical treatment has relied on excisional techniques in the past. Physiologic operations have more recently been devised to help improve this condition. Assessing patients and deciding which of the available operations to offer them can be challenging. MRI is an extremely useful tool in patient assessment and treatment planning. J. Surg. Oncol. 2017;115:18–22. © 2016 Wiley Periodicals, Inc.