すみません。できました。
using System;
using System.Collections.Generic;
using System.Web;
using System.Web.Services;
using System.Xml;
namespace websvrtest
{
  [WebService(Namespace = "http://tempuri.org/")]
  [WebServiceBinding(ConformsTo = WsiProfiles.BasicProfile1_1)]
  [System.ComponentModel.ToolboxItem(false)]
  public class Hoge : System.Web.Services.WebService
  {
    [WebMethod]
    public XmlDocument HelloWorld()
    {
      XmlDocument dom = new XmlDocument();
      dom.LoadXml("<?xml version=\"1.0\"?><aa></aa>");
      XmlElement el = dom.CreateElement("hoge");
      el.SetAttribute("aaa", "bbb");
      dom.DocumentElement.AppendChild(el);
      return dom;
    }
  }
}