The cause of thrombotic superficial phlebitis of the lower limbs is mainly saphenous varicose vein, which is one of the common complications of saphenous varicose vein. In patients with saphenous varicose vein, the saphenous vein valve is incompetent and blood flows backwards, resulting in blood stagnation in the main trunk of the saphenous vein and its branches, slowing blood flow and making it easy to form thrombosis, while inducing an inflammatory response in the vein wall and surrounding tissues, resulting in acute thrombotic superficial phlebitis. The clinical manifestation is the hardening of the original varicose vein masses on the inner side of the lower extremity, the obvious redness and swelling of the surrounding tissues, and the obvious pain and pressure pain. In some patients, saphenous vein thrombosis may multiply to femoral vein (deep vein trunk), leading to deep vein thrombosis of lower limbs and even pulmonary embolism, which is life-threatening. In China, Jinxing et al. reported that the thrombosis of superficial veins in thrombotic superficial phlebitis of lower limbs directly caused pulmonary embolism. The traditional treatment method of saphenous varicose vein with thrombotic superficial phlebitis is conservative treatment, applying antibiotics, blood-stasis activating drugs and topical magnesium sulfate or heat-clearing and detoxifying herbal medicine, and then surgical treatment of saphenous varicose vein after the thrombotic superficial phlebitis subsides. However, some patients with thrombotic superficial phlebitis are slow to subside by conservative treatment, and even aggravate, causing deep vein thrombosis of lower limbs and even pulmonary embolism, leading to serious consequences. It has been reported that the course of thrombotic superficial phlebitis of the lower limbs is as long as 13 months, and the author has encountered a patient with typical symptoms of saphenous varicose vein secondary to thrombotic superficial phlebitis in the clinic, and the symptoms and signs have not been significantly relieved by conservative treatment for half a year. In China, Du Liping et al. advocated active surgery for thrombotic superficial phlebitis caused by varicose veins in the lower limbs, and Yang Benxun et al. reported that early surgery for primary varicose veins in the lower limbs with thrombotic superficial phlebitis achieved satisfactory results. We believe that thrombotic superficial phlebitis secondary to saphenous varicose veins is a sterile inflammation of the surrounding tissues induced by thrombosis of the saphenous vein, and early surgical debridement of the thrombus in the saphenous vein and its genetic branches and within the period will rapidly subside the inflammatory reaction of the surrounding tissues and the patient’s symptoms will be rapidly relieved due to the removal of the cause and the lesion. Small incision saphenous vein high ligation and stripping is the most thorough treatment for saphenous varicose veins, and it is the treatment of choice because it is less invasive, quicker to recover, and does not affect aesthetics. We believe that early surgery should be performed when saphenous varicose vein is complicated with acute thrombotic superficial phlebitis, without conservative treatment until the inflammatory reaction subsides, and early minimally invasive surgical treatment, i.e. small incision saphenous vein high ligation and stripping, solves both problems of acute thrombotic superficial phlebitis and saphenous varicose vein at one time, significantly shortens the course of treatment, reduces the patient’s pain and treatment cost, and is the most effective treatment method at present. So far, we have used early minimally invasive surgery to treat dozens of patients with saphenous varicose veins with acute thrombotic superficial phlebitis, and all of them recovered rapidly after surgery, and the symptoms such as local redness, swelling and pain were relieved rapidly, and all of them had good healing of incision after surgery, and none of them had incision infection, which obviously shortened the course of treatment, reduced patients’ pain and treatment cost. Figure 1 Thrombotic superficial phlebitis caused by saphenous varicose vein, with obvious redness and swelling around the varicose vein mass. Figure 2 The same patient with intraoperative removal of the saphenous vein and thrombus. Figure 3 The same patient, two weeks after the small incision saphenous vein high ligation stripping, the tortuous vein mass completely disappeared, the inflammation subsided, and all incisions healed at grade A. Figure 4 The same patient, 1 month after surgery, the varicose vein mass completely disappeared and the incision was not obvious.