”Doctor, do I need surgery for my varicose veins?” This is a question we often hear in vascular surgery clinics. Varicose veins in the lower extremities are a common vascular surgical condition. Clinically, it is common to see tortuous and dilated veins in the lower legs, skin desquamation, hyperpigmentation, eczema and ulcers. Patients often already know the diagnosis of varicose veins in the lower extremities at the time of their visit to the doctor. Therefore, more patients are concerned about how their varicose veins are treated. The varicose veins of lower extremities should firstly exclude the superficial varicose veins caused by deep vein thrombosis, arteriovenous fistula, deep vein valve insufficiency, etc. The following treatments are available for simple varicose veins of lower extremities. Conservative treatment includes wearing medical elastic stockings, taking oral medication to promote venous and lymphatic reflux, etc. It is suitable for mild varicose veins, varicose veins during pregnancy and old and weak people who cannot tolerate surgery. Surgical treatment includes superficial vein spot stripping, laser vein closure, microwave vein closure, superficial vein planing aspiration, and superficial vein sclerotherapy injection. Among them, saphenous vein high ligation, superficial vein spot stripping and laser vein closure are among the commonly used methods. Surgical treatment is indicated for moderate and severe varicose veins. In patients with complications such as ulcers and eczema, surgery can be performed after infection control to promote ulcer healing and control the development of eczema. Of course, the indications for surgery should also take into account the patient’s quest for quality of life. For simple mild to moderate varicose veins in the lower extremities, laser vein closure can be performed if the patient considers aesthetic reasons, and there are basically no scars on the lower legs. Therefore, the indication of surgery for varicose veins of lower limbs is the unification of biological and sociological indications. The appropriate treatment method is proposed based on full consideration of the fundamental interests of the patient.