Saphenous varicose veins of lower extremities are common diseases in vascular surgery, mainly manifesting as tortuous dilatation of superficial veins of lower extremities, with early manifestation of worm-like bruising and dilatation of superficial veins of lower extremities, soreness, discomfort and pain when standing, and disappearing when walking or lying down. When the disease progresses to the later stage, the skin of the lower limbs becomes nutritionally impaired due to poor blood circulation, and skin atrophy, desquamation, itching, pigmentation, skin and subcutaneous tissue sclerosis, and even eczema and ulcer formation occur. Especially in the back of the foot, ankle and lower leg, when serious or after trauma, the skin is ulcerated and does not heal for a long time, commonly known as “old rotten leg”. There are many causes of saphenous varicose veins, which can be divided into congenital genetic factors and acquired factors. The acquired factors include prolonged standing, heavy work, pregnancy, chronic cough, habitual constipation and so on. No matter what the cause is, it will lead to the tumor-like expansion of the saphenous vein valve, so that the valve at the confluence of the superficial and deep veins of the lower extremity will lose the role of “one-way valve”, causing the blood return barrier to the lower extremity, and the venous blood will backflow and stasis in the saphenous vein, thus making the vein tortuous and dilated. The principles of saphenous vein treatment are divided into non-surgical treatment and surgical treatment. The non-surgical treatment can only improve the early symptoms by elevating the limb, elastic bandages, and elastic stockings, etc. It is suitable for those who have limited symptoms, those who develop symptoms during pregnancy, and those who cannot tolerate surgery despite the obvious symptoms. Surgery is the fundamental method of treating varicose veins in the lower extremities, and is suitable for patients whose deep veins are usually not contraindicated to surgery. The valves in the varicose veins have been destroyed and the blood is flowing backwards, which not only fails to return the blood normally, but also makes the blood flow backwards or forms dead circulation locally, so the basic principle of varicose vein surgery is to remove or close these diseased veins. Surgical treatment includes classical high saphenous vein ligation + trunk stripping + varicose branch vein stripping and laser, radiofrequency, microwave and sclerotic closure. The classical saphenous vein ligation + trunk stripping + varicose branch vein stripping is gradually replaced by newer methods because it is more traumatic for the patient and the postoperative recovery is slower, especially when the incision is large, which often causes complications such as delayed healing or infection. Sclerotherapy, i.e., local sclerotherapy injection and closure of blood vessels, is no longer used in regular hospitals in China because of the high recurrence rate and many complications. Although extravascular laser or pulsed light has the advantages of local anesthesia, short treatment time, low pain, rather small wound, no unsightly scars, and immediate walking, it can only target microscopic spider varicose veins, and is expensive and requires several sessions to be effective, which is not affordable for general patients. With the advent of saphenous vein laser treatment, we see the possibility of minimally invasive or even non-invasive saphenous vein surgery, especially for young women who are afraid to go to the doctor for fear of leaving surgical incision scars, and at a lower cost. Endovenous laser treatment of the saphenous vein involves the insertion of a light-guided fiber into the patient’s diseased vein, which, through the effect of laser pulses, causes coagulation and contraction of the inner wall of the vessel, resulting in solidification, fibrosis and occlusion of the vein. This procedure has the advantages of safety, minimally invasive, less painful, fast recovery, and precise efficacy, etc. This procedure has been widely accepted by patients in recent years, and its application in clinical practice is becoming more and more common. In order to prevent laser fiber from accidentally entering the femoral vein, our department has been carrying out high saphenous vein ligation combined with endovenous laser treatment (EVLT) since 2012, and hundreds of patients have been able to solve their pain. For mild to moderate saphenous varicose vein, basically no incision is needed, a small incision is made at the fossa ovalis to ligate the saphenous vein and then a cannula is placed in the saphenous vein next to the ankle. For multiple varicose clusters in the lower leg, it is only necessary to insert the optical fiber through the puncture needle to destroy them one by one. However, for patients with severe saphenous varicose veins, especially if the varicose veins are tortuous, laser treatment combined with small incisional punctiform aspiration is necessary. This can significantly reduce the surgical incision and bleeding, significantly shorten the operation time, less traumatic surgery, and the treatment effect is obvious. After the operation, the affected limb should be wrapped with elastic bandage and elevated 20~750px above the heart, and the ankle joint should be moved and the dorsiflexion of the foot should be performed to promote venous blood return. You can eat 6 hours after surgery, and you don’t need to be bedridden for a long time after surgery, you can get out of bed in the next day or three days, the pain is light and the recovery is fast. Varicose veins of lower limbs is a disease that must be taken seriously and treated promptly. Clinically, some patients have a wrong idea that they feel that there are no symptoms in the early stage of varicose veins, no pain, no itch and they don’t want to go to hospital for treatment until they feel painful when complications appear, which increases the difficulty of treatment, slow recovery and corresponding increase in cost. Therefore, we call for early detection and treatment for patients.