Abstract Background: Varicose veins are the main manifestations of chronic venous disease (CVD), and present as dilated and elongated incompetent superficial veins in the lower limbs. The most common method of treatment for this condition is an open surgery proposed by W. Keller 110 years ago. Endov-enous LASER ablation (EVLA) was proved to be effective in the treatment in many randomized controlled trials. Aim of Study: To throw light and compare (EVLA) to conventional surgery in treating primary varicose veins in lower limbs. Patients and Methods: This prospective study included 40 patients, who were treated for symptomatic varicose veins of the lower limbs divided into two groups. In first one, 20 patients underwent open surgery (the surgery group), while in the other, 20 patients received the EVLA (the EVLA group). The patients were invited to follow-up evaluations at first and second weeks then one and six months after the surgery. Results: VCSS scores at one month were better in the EVLA group (median VCSS scores 1 (0-2) vs. 4 (3-5), p < 0.0001). Patients in the EVLA group experienced less post-operative pain (p < .00163). In addition, patients in the EVLA group managed to return to work and normal activities sooner than those in the surgery group (p < 0.0001). No statistically significant differences were found between groups for overall satisfaction, rate of complications except hematoma which was higher in surgery group. Conclusion: Both treatment techniques yielded similar results in terms of efficacy, complications and overall patient satisfaction. However, early postoperative results in the EVLA group were superior to those of patients in the surgery group.