Whether it is necessary to treat patients with iliac vein compression syndrome should be analyzed in relation to the severity of the condition. Iliac vein compression syndrome is mainly due to various reasons that lead to iliac vein compression, thus inducing pelvic venous return obstruction, indirectly leading to increased venous pressure in the lower limbs, which may induce varicose veins and other lesions in the lower limbs. However, the clinical symptoms of patients vary according to the severity of their illness. If the patient’s clinical symptoms are not too obvious, or if the iliac veins have already shown obvious side branch compensation, the lesion has a relatively small impact on the patient’s life. In this case, no treatment is needed for the time being, and the patient should be followed up closely to monitor the development of the lesion. If the patient develops obvious clinical symptoms, such as lower limb edema, pain, fatigue, calf skin ulceration, hyperpigmentation, prolonged menstrual period and increased menstrual flow in female population, then active treatment is needed. The specific choice of treatment program should be carried out in accordance with the doctor’s instructions.