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Objective: Chronic venous disease (CVD) is accompanied by a spectrum of skin changes. The aim of this study was to assess skin changes in CVD in different classes of the classifications such as the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification using ultrasound (US). Methods: This study was conducted from July 2020 to July 2021 after obtaining approval from Institutional Ethical Committee. Patients with chronic venous insufficiency were enrolled after taking informed consent. Assessment of cutaneous layer (CL), subcutaneous layer (SCL), dermo-hypodermal junction (D-HJ), and other significant US findings were noted. Results: Ninety-eight limbs were evaluated. Most common skin finding was dermal edema in 59 (60.2%) legs. Other findings included infiltrates, CL thickening, hyper echogenicity and thickening of SCL, anechoic lacunae, disappearance of D-HJ, and epidermal loss or change in thickness of epidermis. Notably, US detected dermal edema in 15 and infiltrates in five C2 legs (normal on inspection). Conclusion: US evaluation of skin changes adds insight to clinical assessment and may reveal skin changes in legs affected with CVD that may appear normal on clinical examination. [ABSTRACT FROM AUTHOR]