Surgical stripping of the varicose saphenous venous systems combined with avulsion and extraction of collateral branches through very small incisions has yielded excellent cosmetic and functional results in 1,500 operative procedures. Sclerotherapy of varicose veins is an established procedure. Injection with the patient in the upright position followed by mild short-term compression is a simple method to achieve the desired results, but is reserved for treatment of collateral varicose veins more than 4 mm in diameter. Obliteration of intracutaneous telangiectasia and small subdermal veins of the legs, face, and trunk can be done safely by injecting a 0.1% solution of sodium tetradecyl sulfate through a 30 or 32 gauge needle directly into the lumen of the vessel. Slow intraluminal injection has resulted in uniformly good to excellent results in more than 350,000 puncture sites. By combining surgical and sclerosing techniques, maximal functional and cosmetic results can be obtained by removing or obliterating venous channels.