Aim: Despite compression therapy being the gold standard care for venous leg ulcers (VLUs), patient compliance with four-layer compression bandage (4LB) is poor. The Dual Compression System bandage (DCS) is a 2 Layer Bandage (2LB) and improves wound closure rate. The objective this study was to estimate the cost-effectiveness (CEA) the 2LB compared to 4LB to heal one additional VLU. 2LB is more expensive due to its use of advanced materials. Method: We conducted a patient-level microsimulation model to do cost-effectiveness analysis from the US perspective. All clinical data was obtained from a prospective clinical trial. Cost data were obtained from structured literature review and pragmatic metaanalysis adjusted to 2021 USD using the Consumer Price Index. The effect measure was the avoidance of one VLU. The primary outcome was the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses (PSA) were performed to gauge the robustness/reliability of the results. Results / Discussion: The incremental cost-effectiveness ratio was $1,168 per VLU healed. One would expect to pay $1,168 more with the 2LB system to heal one additional wound versus the 4LB system. For every 100 patients, the additional cost of a 2LB system was expected to be $6,255 but 5 additional wounds would be healed compared to a 4LB. Accounting for the savings from these additional wounds healed, we project savings of $16,580 per 100 patients treated. Conclusion: The 2LB system was a cost-effective strategy for the treatment of VLUs compared to a 4LB system. Further, the 2LB system has been shown to increase patient satisfaction. Adoption of the 2LB should be considered a value-added adjunct to the management of VLUs.