Several patients with recurrence of varicose veins after surgery from a distance were recently seen. Ultrasound localization revealed that the varicose veins recurred several years later due to missed traffic branch lesions and neglected small saphenous lesions, and the patient had to undergo surgery again. Such recurrence could have been avoided if the surgeon had done the preoperative ultrasound in person. Pre-operative ultrasound examination and localization by the surgeon in person is a routine procedure for varicose vein treatment in developed countries and has the following effects: 1. Avoid missing 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 examinations. Therefore, it is easy to lead to postoperative recurrence. 2. Through ultrasound positioning, detailed blood flow direction 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 lighter, the chances of incision infection will be less, and the appearance will be beautiful. 3. The surgeon personally does the preoperative ultrasound examination, which can make a more effective judgment on the root cause of the disease and reduce the occurrence of complications. Varicose veins are not a major disease, but each patient’s varicose veins have their own peculiarities. Pre-operative ultrasound examination by the attending surgeon allows for individualized treatment design and minimizes needless recurrence and complications. In addition, it is important that the patient is in a standing position, closest to the position in which the disease develops. Otherwise, venous emptying after lying flat can easily lead to erroneous judgments.