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Venous lake lesion is a venous ectasia that can occur on the lips of older people. Although different therapies have been used, there is no guideline for treating this lesion. The purpose of this study was to evaluate whether sclerotherapy is an effective and acceptable option for treatment of venous lake lesions of the lips in older patients.Medical records and images were retrieved from the archives of a geriatric dentistry clinic between 2005 and 2017. A total of 33 older patients treated with 5% ethanolamine oleate were included. Clinical information was selected and described.The female gender was predominant (64%), and the patients’ age ranged from 66 to 90 years. The majority of the patients were Caucasian (91%), and 82% were under treatment for hypertension. In 91% of the cases, the lesions were located on the lower lip and varied from 3 to 10 mm in diameter. A complaint period lasting longer than 2 years was reported by 58% of the patients. Color alteration was the most common type of esthetic complaint. Only one application of sclerotherapy was performed in 85% of the cases. For the remaining patients, two sessions were necessary. The total dose ranged from 0.3 to 0.9 ml. Complete regression of the lesions was observed in all cases. No complications or recurrences were reported.Sclerotherapy with ethanolamine oleate is an effective, affordable, and predictable treatment for venous lake lesions of the lips in older patients.