Bernard O’Brien’s foundation work in Lymphovascular anastomosis (LVA) microsurgery has revolutionized the treatment of lymphatic disorders. Working at the Microsurgery Research Centre at St. Vincent’s Hospital in Melbourne, he was instrumental in shaping the early evolution of lymphatic surgery. O’Brien’s groundbreaking research began in the 1970s, with his early experimental studies on canine models successfully demonstrating improvements in lymphatic flow after LVA. This then paved the way for the technique to be adopted in human trials, and by 1990, he published the largest series of LVA surgeries, cementing the procedure as a key option for lymphedema. He later continued to develop techniques for vascularised lymph node transfer (VLNT) through similar canine models. Therefore, laying the groundwork for future advancements in lymphatic surgery. This presentation explores O’Brien’s transformative impact on lymphovascular microsurgery, highlighting how his research, clinical work, and teaching have shaped the field. His dedication to improving patient outcomes, combined with his role as a global leader in lymphatic surgery, has set a new standard in the treatment of lymphatic and vascular disorders.