Background: Manual lymphatic drainage (MLD) is a well-recognised and traditional treatment modality for oedema. HIVAMAT® 200 is a novel device that uses an intermittent electrostatic field to stimulate blood and lymphatic flow, thereby reducing oedema. This study aims to compare the effects of MLD alone to HIVAMAT® 200 plus MLD. Method: Three females with lipoedema and two males with lymphoedema were recruited. The larger leg was treated with HIVAMAT® 200 plus MLD and the contralateral limb with MLD only over the course of 3 weeks. Efficacy of treatment was determined with measurements of leg volumes and high-definition ultrasound to analyse oedema. Results: The mean reduction in volume for the HIVAMAT® 200 plus MLD-treated legs was 902 ml (SD 793 ml) and the mean reduction in MLD-only legs was 707 ml (SD 630 ml). While there was greater improvement in the HIVAMAT® 200-treated limb, this was not statistically significant (p=0.06). Using high-definition ultrasound to analyse oedema, the limbs treated with HIVAMAT® 200 plus MLD showed significantly greater reduction in levels of oedema than the limbs treated with MLD alone (p=0.017). Conclusion: HIVAMAT® 200 reduces lower-limb oedema and is at least as efficacious as MLD in achieving volume reduction. Prospective studies with larger numbers of participants are required to further evaluate this.