On 13 patients, 22 ischemic skin ulcers which had resisted a variety of therapeutic agents were treated with ordinary gold leaf. Three coexisting lesions served as controls. After initial cleansing and debridement, the ulcers were wetted with 95% alcohol, covered with four to eight layers of gold leaf, and protective dressings were applied; this procedure was repeated every 48 hours. A venous-stasis lesion decreased in size 86% in one month, and a diabetic ulcer showed 44% improvement in 11 days. Twenty decubitus ulcers decreased an average of 62%, and three coexisting control ulcers increased in size an average of 96%. Deterrents to successful treatment include a hemoglobin value below 12 gm/100 cc, excessive friction, undermining of ulcer edges, ringing of the lesion with scar tissue, and copious purulent discharge. No adverse reactions to gold leaf were observed.