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Joint dysfunction occurs frequently in patients with venous malformations of the extremities. This study aims to describe the risk factors of joint dysfunction in these patients.We retrospectively collected clinical and radiological aspects of 168 patients with extremity venous malformations from January 2013 to August 2015. Patients were categorized into “with joint dysfunction” or “without joint dysfunction” groups according to the symptoms.Forty-four (26%) patients were assigned into with joint dysfunction group. Univariate analysis showed that the significant variables were age (P = 0.008), location (P = 0.005), size (P < 0.001), involved tissue (P < 0.001), visual analogue scale scores of pain (P = 0.004), pain duration (P = 0.018), and therapy history (P < 0.001). Multivariate analysis showed that the factors associated with joint dysfunction were age below 10 years (adjusted odds ratio = 2.70, P = 0.004), lower limb (adjusted odds ratio = 2.72, P = 0.042), pain duration over 1 year (adjusted odds ratio = 3.47, P = 0.001) and therapy history (yes) (adjusted odds ratio = 3.71, P = 0.004).This study provides preliminary evidence indicating which patients are at high risk for joint dysfunction associated with limb venous malformations.