The incidence of varicose veins in the lower extremities has now reached about 5% of the total population in cities. Based on such a high incidence, vascular surgery has sprung up all over the country in recent years. Varicose veins of the lower extremities have become the leading disease in vascular surgery outpatient clinics or wards around the country. Traditionally, varicose vein surgery is to strip the saphenous vein trunk while making multiple incisions to strip the varicose veins in the lower leg, and this surgical approach is more invasive due to the many incisions, making the patient’s hospital stay generally about a week. In recent years, minimally invasive treatments for varicose veins have gradually emerged. Endovenous laser closure (EVLT) is a procedure that uses a special wavelength laser to intervene in the saphenous vein trunk through fiber optics and then perform vein closure, a technique that to some extent avoids some of the complications associated with aspiration of the saphenous vein. For example, hematoma, saphenous nerve damage, etc. Other techniques that are similar to the laser are: radiofrequency closure and cryo-closure. All 3 techniques have in common the avoidance of saphenous vein aspiration. However, they cannot do anything for the varicose veins in the lower legs and often have to be combined with traditional stripping surgery. The high recurrence rate of laser treatment in clinical practice occurs mainly in cases of inexperience of the surgeon and excessive caliber of the saphenous vein. In addition, discomfort due to striae phlebitis in the thighs one week after laser treatment is one of the main complaints of many patients. The Trivex technique, designed for patients with extensive varicose veins in the lower leg, uses a subcutaneous light source to locate the varicose veins, which are then removed using a trivex system. This technique solves the problem of varicose veins in the lower leg by making only 2 incisions in the lower leg. However, the aspiration technique is not applicable to the trunk of the great saphenous vein. Also the planar aspiration is not strictly minimally invasive, it appears to have few and small incisions, but the subcutaneous trauma is greater. Sclerotherapy injection sounds like a good technique that requires no anesthesia, no incisions, and is inexpensive. However, there are significant risks associated with sclerotherapy injections; one is that skin necrosis can result from extravasation of the sclerosing solution. Second, once the sclerosing agent flows into the deep vein, it can lead to thrombosis, and in serious cases, pulmonary embolism. In recent years, the international sclerosing agent injection has made a series of improvements, such as: the emergence of microfoam technology (microfoam), which can make the occlusion effect better while reducing the concentration and amount of sclerosing agent, greatly avoiding the past complications. However, sclerotherapy injections are very ineffective in the management of the saphenous vein trunk. In clinical practice, the high recurrence rate and the factors of the domestic medical environment make it not widely used. Vascular surgery throughout China has adopted the above techniques in recent years and has made great progress and achievements in the treatment of varicose veins. However, in an overview, there are still some problems in the treatment of varicose veins in China. First, the problem of excessive medical treatment. Varicose vein surgery is a relatively common surgery, and the preoperative diagnosis should be relatively simple and clear for most patients. It should be said that for an experienced vascular surgeon, a clear diagnosis can be made through physical examination. Thus, it seems that most patients do not need ultrasound and imaging of deep veins before surgery. In fact, a significant number of providers use deep vein imaging, putting the patient at risk for a number of complications associated with the imaging. For example, allergy to the contrast dose or thrombosis. It also significantly increases the cost of treatment for the patient and increases the waiting time for the procedure. However, venography is necessary for less experienced physicians or for more difficult clinical cases. It is also inappropriate for many providers to treat varicose vein surgery patients with antibiotics in the postoperative period. This is because saphenous vein surgery, in the absence of an infected ulcer, is a sterile procedure and there is no indication for the use of antibiotics. These unscientific pre- or post-operative measures can be considered, to some extent, as “overmedication”. There are factors such as the doctor’s philosophy and academic level, and there is no denying that there is a financial profit motive. Second, the choice of surgery. There are many medical institutions that depend on the equipment that the institution has in choosing the procedure rather than on the specific condition of the patient. As the equipment for varicose vein treatment is expensive, such as laser, radiofrequency, shaving suction and other equipment are more than hundreds of thousands of RMB, most of the hospitals only purchase one of the equipment. Therefore, in marketing, most hospitals only advertise how good the technology of their equipment is and exaggerate the scope of their treatment. It is not difficult to understand that some hospitals say that laser is the best means of treating varicose veins. Another hospital claims that radiofrequency is the best treatment for varicose veins. These statements are actually not scientific, as introduced at the beginning, each device has its advantages and disadvantages, and one of them or a combination of them should be used according to the patient’s specific condition. Third, the evaluation of the treatment effect. Strictly speaking, varicose veins are the clinical manifestation of many kinds of diseases. In addition to the aesthetic changes in the image, varicose veins themselves are not harmful to the body, but some complications brought about by the long-term development of varicose veins, such as: thrombosis, ulcers, edema, etc., are the main factors that affect the daily life of patients. So the main purpose of treatment of varicose veins is to prevent these complications or for cosmetic purposes. The evaluation of the results of varicose veins should focus on the patient’s perception and improvement in quality of life, and the long-term results should be followed up. Some providers use sclerotherapy injections to make varicose veins disappear in the short term, but most patients have a recurrence after several years due to untreated diseased trunk veins. The evaluation of laser and radiofrequency procedures has also revealed over the years the possibility of recurrent recurrence of the saphenous trunk if not performed by experienced surgeons. The planar aspiration technique has only two incisions, but the extent of the trauma is mostly subcutaneous, so the postoperative subcutaneous bruising is more severe and requires longer bandage wrapping, which is difficult for Chinese patients to accept the relatively slow postoperative recovery. In addition, since the fees for varicose vein surgery are not high, the benefits to the provider are very low and therefore the above mentioned over-medication occurs: the patient’s hospital stay is unnecessarily prolonged and the costs are unnecessarily increased. If we understand the above mentioned problems, we should know that we cannot blindly tell the patient what is the best technique, but only what is the most suitable after examining the patient. The standardized treatment process for varicose veins should be within two days of hospitalization. (Except for patients with other medical conditions, of course.) With the maturation of minimally invasive techniques and shorter hospital stays, varicose vein treatment has become easier than ever, so that patients who were apprehensive about surgery will revert to it. It is expected that the number of varicose vein patients in vascular surgery will increase, and the demands on the surgeon will become higher and higher. As a vascular surgeon, it is important to insist on scientific care and continuous innovation.