The prevalence of varicose veins in the lower extremities is about 7% in the population. The main pathogenesis of varicose veins in the lower extremities is the incomplete closure of the valves of the saphenous vein into the deep veins, which leads to backflow of blood and increases the pressure in the veins, causing them to dilate and twist over time, called varicose veins. Varicose veins usually occur first in low places, such as the lower legs. Varicose veins can develop for several years, or even more than a decade, without obvious clinical symptoms. But this does not mean that varicose veins are not harmful. As the disease progresses, complications such as intravenous thrombosis, sterile inflammation (phlebitis), hyperpigmentation, ulcers, bruising dermatitis, and ruptured bleeding can occur. In the past, the idea was that asymptomatic varicose veins or elderly patients could be treated conservatively first, including medication or compression stockings. This view has a certain universality and is based on considerations such as high surgical trauma, high economic burden, and surgical risk in the patient’s advanced age, which is also justified. However, medical development today, the answer to the question of whether “early surgery or first conservative treatment is better for varicose veins?” The answer to this question has undergone a subtle change. More and more varicose vein patients are opting for early and minimally invasive surgical treatment. First of all, drugs and compression stockings, as the main means of conservative treatment for varicose veins, can only delay the progression of the disease but not treat the root cause of varicose veins. Therefore, drugs can only be used as an adjunctive treatment after varicose vein surgery in the lower extremities. Although the effect of elastic stockings is exact, they need to be worn for life, and they are troublesome and expensive to use. At present, the vast majority of patients who initially wear compression stockings eventually opt for surgery. So. Since surgery is required in the end, the time and effort spent on conservative treatment is wasted. Advances in medicine have also made surgery for varicose veins in the lower extremities increasingly minimally invasive. The adoption of minimally invasive surgery has resulted in a much shorter hospital stay, with discharge from the vascular surgery department of the autonomous people’s hospital taking only about a week. However, minimally invasive surgery is only suitable for early varicose veins. One of the consequences of the development of varicose veins is that as the blood from the deep veins flows back to the opening of the diseased saphenous vein, it flows backwards into the superficial venous system, creating an ineffective circulation and increasing the burden on the deep veins, which, over time, leads to or aggravates the degree of deep venous valvular lesions. The severity of the deep venous lesions is an important factor in the chance of recurrence after varicose vein surgery. Once the condition reaches the point of venous thrombophlebitis, edema, hyperpigmentation, bruising dermatitis, or ulceration, the effectiveness of the procedure is greatly reduced. For example, surgery does not eliminate the darkening of the skin, surgery is very ineffective for edema, and surgery is less than 80% effective for bruising dermatitis. Phlebitis also takes a long time to subside. In elderly patients, the general condition of the patient deteriorates with age. If they do not undergo minimally invasive surgery in the early stages and develop varicose vein complications later, they often cannot be treated because they cannot tolerate surgery. Therefore, in order to avoid these complications, the best option is to have early surgery to resolve varicose veins before complications arise. In summary, the drawbacks of conservative treatment of varicose veins are: (1) the side effects of medications; (2) the use of compression stockings diminishes the quality of life (e.g., too hot in summer, hard to wear, having to buy new stockings every year). (3) Risk of disease progression and loss of the opportunity to choose minimally invasive surgery. (4) Significantly higher rates of surgical recurrence and failure once complications arise. Although varicose vein surgery has a certain rate of recurrence, even if recurrence occurs, it is much better than if complications occur without surgery. However, most recurrences are related to the clinical experience and skill of the surgeon. So, it is a prerequisite to choose an experienced vascular surgeon to perform the surgery. Because, a surgeon who lacks experience in varicose vein surgery or if traditional open surgery is used, post-operative complications can occur quite a lot.