Recently there have been several cases of postoperative recurrence of varicose veins from afar. Ultrasound localization revealed that due to missed traffic branch lesions and neglected small saphenous vein lesions, the varicose veins recurred after a few years and the patients had to undergo surgery again. Such recurrences could have been avoided if the attending surgeon had done the preoperative ultrasound to localize them. Preoperative ultrasound localization by the surgeon is a routine procedure in the treatment of varicose veins in developed countries and has the following effects: (1) Avoidance of missed lesions. Traffic vein and small saphenous vein lesions are often not obvious in appearance and must be detected by ultrasound, but the ultrasound reports of almost all hospitals in China lack the description of these two tests. Therefore, it is easy to lead to postoperative recurrence. (2) Through ultrasound localization, the detailed direction of blood flow and lesion release can be understood, and precise incision selection can be made to reduce blind incisions. With fewer incisions, the postoperative pain will be less, the incision will have less chance of infection, and the appearance will be beautiful. (3) The surgeon himself does the preoperative ultrasound examination, which can make judgment on the root cause of the disease more effectively and reduce the complications. Varicose veins are not a major disease, but each patient’s varicose veins are unique. Pre-operative ultrasound examination by the surgeon can make the treatment individualized and designed to minimize unnecessary recurrence and complications. In addition, it is important that the patient stands in the position closest to where the disease develops. Otherwise, the veins empty after lying flat, which can easily lead to misjudgment.