Lymphatic filariasis is a vector-borne neglected tropical disease that causes damage of the lymphatic system and can lead to lymphoedema (elephantiasis) and hydrocele in infected individuals. The global baseline estimate of persons affected by lymphatic filariasis is 25 million men with hydrocele and over 15 million people with lymphoedema. At least 36 million persons remain with these chronic disease manifestations. The disease is endemic in 72 countries. In 2016, an estimated total population of 856 million were living in areas with ongoing transmission of the causative filarial parasites and requiring mass drug administration (MDA). Lymphatic filariasis disfigures and disables, and often leads to stigmatization and poverty. Hundreds of millions of dollars are lost annually due to reduced productivity of affected patients. WHO has ranked the disease as one of the world’s leading causes of permanent and long-term disability. This guideline serves as a response to countries that have requested WHO to devise alternative regimens to realign their national programmes towards elimination by 2020.