The principles of the operation are to ligate the point of junctional incompetence and to remove the refluxing trunk and dilated tributaries. Preoperatively, a careful consent is taken, explaining the risks of infection, minor nerve injury and recurrence, the varicose veins must be tramlined using an indelible marker pen to enable accurate identification varicosities during surgery. The operation is usually performed under general anesthesia but locoregional anesthesia is possible. This chapter covers the saphenofemoral ligation and long saphenous stripping, saphenopopliteal junction ligation and lesser saphenous stripping, perforator ligation, phlebectomies, conservative venous ligation, postoperative instructions, complications of standard varicose vein surgery, minimal invasive methods, radiofrequency ablation, recurrent varicose veins, and comparison of interventions.