Background: Varicose veins are common in the adult population and about one in four develops the condition throughout life. Objective: To compare micro stab phlebectomy and foam sclerotherapy in the treatment of recurrent leg varicose veins regarding results of treatment, incidence of complications, and recurrence. Patients and methods: This was a prospective observational cohort study included fifty patients with recurrent varicose veins divided in two equal comparative groups:  Group A underwent stab phlebectomy and group B underwent foam sclerotherapy. The study duration was between January 2020 and November 2020 at the Department of Vascular Surgery, Al-Azhar University Hospitals (Al-Hussein and Bab Al-Shaareia University Hospitals). Results: Thirty males and twenty females were included. Mean age (years) was 35 and 34 in phlebectomy and foam sclerotherapy groups, respectively. No significant difference between the two groups according to age and sex. The prevalence of recurrent lower limb varicose vein was found to be more common in males than in females in the vicinity of this study.      Dilated veins were the most common involving in 60 % (n = 30/50) of the patients. The primary symptom of the patients relieved in 80 % and 56% in phlebectomy and foam sclerotherapy groups, respectively. Time taken in procedures was significantly different between the two groups.      During the follow-up with duplex at 6 months, treated veins showed 92 % (n =23/25) removal of treated veins in the phlebectomy group, while only 72% (n=18/25) of the patients in the foam group showed evidence of complete occlusion. Recurrent varicose veins were found in 4 % (n = 1/25) of the patients in the phlebectomy group, while 16 % (n =4/25) of the patients in the foam sclerotherapy group had recurrence. Conclusion: Both micro stab phlebectomy and foam sclerotherapy were safe effective in treating recurrent varicose veins with advantage of micro stab phlebectomy regarding to lower recurrence, primary symptom relief and better post procedural outcomes.