<p>Sulodexide is a highly purified glycosaminoglycan with multiple pharmacological effects, including endothelial glycocalyx repair, endothelial cell protection, anti-inflammatory and antithrombotic actions, promotion of fibrinolysis, reduction of blood viscosity, lipid regulation, and anti-oxidative activity. It serves as a potentially effective foundational therapeutic agent for the prevention and treatment of vascular diseases. This consensus integrates current scientific knowledge on the clinical application of sulodexide in vascular diseases, aiming to provide guidance and reference for rational drug use among clinicians. The consensus statements first elaborate on the pharmacological mechanisms and pharmacokinetic profiles of sulodexide. Through a structured review and integration of published basic and clinical research evidence from China and abroad, it summarizes clinical efficacy and safety data for sulodexide in chronic venous disease, venous thromboembolism, peripheral arterial disease, and microangiopathy, highlighting the importance of rational use of sulodexide in vascular disease management. Additionally, based on evidence-based medicine and existing medical guidelines, specific clinical application recommendations are proposed.</p>