Varicose vein surgery of the lower extremities has a certain recurrence rate, for which there are no statistics. However, a considerable number of postoperative recurrences of varicose veins in the lower extremities can be avoided. First, the patient’s saphenous vein was not ligated. Many patients claim to have had saphenous vein stripping and a surgical scar in the groin area, but ultrasound shows that the saphenous vein is still present. This situation is often due to the surgeon’s clinical inexperience and ligating the branch as the main trunk. Or the saphenous vein cannot be found and the ligation is abandoned. Leaving the saphenous vein intact is the most common cause of recurrent varicose veins. Second, sclerotherapy injection. Most domestic sclerotherapy injections for varicose veins are performed in small private medical institutions. Sclerosing only the varicose veins in the lower legs without treating the saphenous vein trunk leads to recurrence becoming almost inevitable. Third, poor closure or recanalization of the saphenous vein by laser or radiofrequency. IV. Inadequate function of the small saphenous vein. The vast majority of doctors easily ignore the presence of lesions in the small saphenous vein at the time of the first surgery. One is because the small saphenous vein is at the back of the calf; the other is because the small saphenous vein is located deeper and the dilatation is not easily detected. The reflux of the small saphenous vein can lead to the reappearance of the varicose vein. V. Deep vein thrombotic disease. The increase in venous pressure in the case of deep vein discomfort leads to ineffective surgery. VI. Traffic vein insufficiency. For patients with severe deep venous reflux leading to traffic vein insufficiency, it is often accompanied by ulceration in the foot and shoe area. Some patients recur after surgery. Seven, segmental ligation. Veins are very richly branched and the vein wall has strong anticoagulant function. Segmental ligation without closure or stripping of the vein often results in the varicose vein remaining due to blood filling. VIII. Stenosis of the iliac veins. This is an important finding in recent years. The iliac vein is deeply located and is disturbed by intestinal gas anteriorly, so ultrasound is not appropriate to detect the lesion. Stenosis of the iliac vein causes elevated venous pressure in the lower extremities, which manifests as valvular insufficiency. Therefore, when recurrent varicose veins are encountered clinically, the following can be done: First, ultrasound to check whether the saphenous vein remains, the small saphenous vein is incompetent or there is traffic vein reflux. Second, to understand the patency of deep veins. The third is to understand the presence of stenosis in the iliac veins. The surgical approach is tailored to the cause of recurrence. If the main saphenous vein is left behind, the purpose can be achieved by using saphenous vein aspiration or closure. In cases of small saphenous vein insufficiency, stripping or closure of the small saphenous vein is done. In the case of the communicating vein reflux, endoscopic dissection of the communicating vein can be used. For iliac vein stenosis, interventional balloon dilation with stenting is used.