Abstract: Objective：To evaluate the clinical efficacy of endovenous laser ablation (EVLA) in the treatment of small saphenous veins varicose (SSV). Methods：A total of 107 patients with small saphenous veins varicose were divided into EVLA group (n=51) and operation group (n=56). EVLA and high ligation and stripping were performed respectively. Outcomes included duration of operation, hospital stay, postoperative pain, complication rates, venous clinical severity score (VCSS), Euro Quality of life (EQ-5D), Body Image Questionnaire (BIQ) after 3 months follow-up, and 1-year recurrence rate. Results：After treatment, the symptoms of both groups were significantly improved. There was no difference between the two groups in VCSS and EQ-5D. The wound satisfaction was higher in EVLA group (P＜0.05), the operation time and hospitalization time were lower than those in the operation group (P＜0.05). No wound infection and deep venous thrombosis occurred in the EVLA group. Four patients had nerve injury in the operation group and only one patient had nerve injury in the EVLA group. Conclusions：EVLA has the same clinical efficacy as conventional surgery, and it is easier to operate. Patients undergoing EVLA have fewer complications and good cosmetic effect.