Even with treatment, thrombotic superficial phlebitis will recur and progress to deep vein thromboembolism in 10% of patients. The goal of primary treatment of superficial thrombophlebitis is to prevent these complications and improve local symptoms. This article provides an overview of the safety and efficacy of parenteral, oral, topical, and surgical treatments for thrombophlebitis. A large, double-blind, placebo-controlled trial enrolling 3002 patients with low-risk thrombophlebitis showed that patients given subcutaneous 2.5 mg sulforaphane sodium daily for 4 days had a lower risk of venous thromboembolic events, progression of thrombophlebitis, disease recurrence, and major bleeding. The risk of progression and recurrence of thrombotic superficial phlebitis was lower with prophylactic and therapeutic doses of low molecular weight heparin compared to placebo, while there was no statistically significant difference in the risk of venous thromboembolic events and major bleeding. Head-to-head trials showed a lower risk of venous thromboembolic events with 30-day moderate or therapeutic doses of low-molecular-weight heparin compared with short-term use of moderate or low-dose low-molecular-weight heparin, with no significant difference in the risk of major bleeding events. There was insufficient evidence of benefit and harm from low-molecular-weight heparin compared with topical heparin gel, nonsteroidal anti-inflammatory drugs, and surgical treatment. The risk of progression and/or recurrence of thrombotic superficial phlebitis was lower with NSAIDs compared to placebo. NSAIDs were not associated with a reduction in venous thromboembolic events. Nine trials showed no association between local treatment of venous thromboembolism and progression or recurrence of thrombotic superficial phlebitis due to small trial samples, low trial quality, and poorly reported studies. Three studies of surgical treatment (saphenofemoral separation, thrombus removal, and vein stripping) and eight studies of oral medications (pulsatilla, heparan sulfate, sulodexide, hydroxybutazone, vitamin K antagonists, and hydroxyrutin) and intravenous therapy (enzyme preparations) did not affect the results here.