INTRODUCTION: Chronic venous disease is a commonly underdiagnosed condition that gradually diminishes a patient's quality of life and imposes a growing burden on healthcare resources. Venous leg ulcers (VLUs) arise as a complication of chronic venous insufficiency and represent the most prevalent type of slow-healing wound in the lower extremities. CASE PRESENTATION: In this case report, we present the successful treatment of a 75-year-old woman with a chronic venous ulcer caused by chronic deep venous insufficiency. The patient had been struggling with an unresponsive venous leg ulcer for 7 years with no improvement from previous treatments. A three-layer Unna boot treatment, including (ZnO NPs) and a two-component compression system was applied, and significant ulcer reduction was observed. DISCUSSION: ZnO NPs impregnated bandages, like those found in an Unna boot, offer compression by wrapping gauze dressing impregnated with ZnO NPs around the patient's leg forming a semi-solid mold around the extremity. A more efficient treatment approach could lead to fewer clinic visits, thereby reducing healthcare expenses by enhancing the method of managing venous ulcers through a combination of compression and simple, cost-effective surface dressing materials. It's worth noting that ZnO NPs have demonstrated significant benefits for wound healing. CONCLUSION: Utilizing ZnO NPs alongside compression therapy has proven highly effective, accelerating healing and offering a cost-effective solution. Further research is needed to study the safety of ZnO NPs.