Recent articles report that surgery can effectively treat secondary lymphedema. Lymphovenous anastomosis with supermicrosurgery technique has become popular for surgical intervention for lymphedema and has an advantage of minimal morbidity. Lymphovenous anastomosis is effective for treating early-stage lymphedema before fibrosis occurs but has limited outcomes in advanced lymphedema. Lymph node transfer is an emerging physiologic surgical treatment for lymphedema that shows promise. The mechanisms of lymph node transfer have been discordant between publications. However, initial reports encourage surgeons to use lymph node transfer to treat lymphedema patients. The authors review the literature on lymph node transfer and discuss its possible mechanisms and its role in lymphedema treatment.