The Leg Lymphedema Complexity Score (LLCS) is a joint effort through the International Lymphedema and Wound Training Institute (ILWTI) and Nova Southeastern University (NSU) to create a tool to assist clinicians in identifying the various contributing factors and complexities of patients presenting with lymphoedema and skin impairments. The goal is to help drive proper examination and differential diagnosis, treatment planning, as well as utilisation of proper resources. This article highlights the development of the LLCS and how it can be incorporated into clinical practice.