Objective To investigate the effect of heated povidone iodine solution on pain intensity and ulcer healing in patients with chronic venous leg ulcer after debridement and dressing change. Methods A total of 58 patients with chronic venous leg ulcer who first visited outpatients and wards of Department of Cardiovascular Surgery, Department of Burns and Department of Plastic Surgery of The First Affiliated Hospital of Naval Medical University from Jun. 1, 2023, to Jun. 1, 2024 were enrolled and randomly assigned to heated group (using 38 ℃ povidone iodine solution for debridement and flushing, n＝29) or normal group (using 24 ℃ povidone iodine solution for debridement and flushing, n＝29). The general baseline data of the 2 groups were compared, the pain intensity and wound bed temperature before and after debridement and dressing change were evaluated, and the change of pressure ulcer scale score for healing during the observation period and ulcer healing rate were observed. Results There were no significant differences between the 2 groups in age, gender, smoking, body mass index, whether the ulcer exudates, infection, duration of ulcer, ulcer area, pressure ulcer scale score for healing or analgesic use within 24 h (all P＞0.05). There was no significant difference in pain intensity between the 2 groups before or after dressing change and debridement (both P＞0.05). The pain intensity during debridement in the heated group was lower than that in the normal group (P＜0.05). There was no significant difference in the temperature of wound bed before flushing between the 2 groups (P＞0.05). The temperature of wound bed in the heated group was significantly higher than that in the normal group immediately after flushing and at the end of debridement and dressing change (P＜0.01, P＜0.05). The pressure ulcer scale score for healing in the heated group showed a trend of being lower than that in the normal group during the observation period, and the ulcer healing rate was significantly higher than that in the normal group (P＝0.033, hazard ratio＝0.452, 95% confidence interval 0.217-0.941). Conclusion In patients with chronic venous leg ulcer, the use of heated povidone iodine solution can reduce the pain intensity during dressing change and debridement, maintain the stability of wound bed temperature, and promote the healing of ulcer.