Despite the growing interest in vascularized lymph node transplant (VLNT), there are still not enough long-term studies with standardized outcomes to support its use. Researchers wanted to see if VLNT was safe and effective by measuring all of the possible outcomes. All consecutive individuals who had VLNT were included in this prospective analysis. Limb volume, bioimpedance, compression requirements, and the occurrence of cellulitis were used as patient-reported outcome indicators. Omentum (73%), axilla (13%), supraclavicular (7%), and groin (3.5%) were the most common donor locations among 89 patients. Long-term monitoring lasted an average of 23.7±12 months. At 2 years after surgery, patients saw significant improvement across all outcome measures, including a 28.4% increase in the Lymphedema Life Impact Scale, a 20% average reduction in limb volume, a 27.5% increase in bioimpedance score, a 93% decrease in cellulitis, and a 34% decrease in the number of patients who needed compression. There was no lymphedema at the donor site, and the few complications that did arise were mild and brief. About 2 years after surgery, patients who had VLNT for their lymphedema reported feeling the full benefits of the treatment. The absence of risk of lymphedema at the donor location makes omentum an excellent option.