Chronic venous disease is an important source of morbidity in Western Europe and the United States. Varicose veins are a common manifestation of chronic venous insufficiency (CVI), a condition caused by weak or damaged vein walls and valves. Veins have one-way valves inside them to keep blood flowing towards the heart. Damaged or weakened valves can cause blood to pool and flow backwards, commonly referred to as reflux. Even though CVI is common in both men and women, it is twice as prevalent in females as in males. Superficial venous insufficiency is treated medically with graded compression stockings, or in advanced disease that is refractory to conservative therapy with either surgery or endovascular procedures such as endovenous laser ablation (EVLA), radiofrequency ablation (RFA), mechanic-chemical ablation, and ultrasonography-guided foam sclerotherapy. Deep venous insufficiency is also managed conservatively with graded compression stockings, but those that fail can be treated with surgical valve reconstruction or valvuloplasty. Venous obstruction syndromes such as May–Thurner syndrome, Chronic axillary–subclavian vein thrombosis or Paget–Schroetter syndrome are treated with endovascular stents or surgical decompression.