Background: Elephantiasis is damage of the lymphatic vessels or destruction of lymph nodes that caused by filariasis infection. It was chronic and slowly progressive disease which decrease function and quality of life. There are two alternative approaches for surgery: reconstructive surgery and destructive surgery. The treatment aims to restore function, reduce physical and psychological suffering, and prevent the complication growth. Method: In this case report, a 43 years old male presented left lower extremity swelling. Based on clinical examination and investigation the patient was diagnosed with elephantiasis of lower extremity and a surgery will be done by Charles procedure. Result: This paper reported a successful Charles Procedure for elephantiasis of lower extremity. Due to the large mass of the tissue, our case was done by two-stage. After healthy granulation tissue is achieved, we planned to do skin grafting. Conclusion: Charles procedure is recommended for elephantiasis and can be adjuvant treatment. Although postoperative complication may occur, with the correct multidisciplinary support, significant improvements in function and quality of life can be achieved.