Background: Varicosities can be definitively treated by either conventional surgery or endovenous ablation techniques, which involve the abortion of venous reflux sources and the removal of significant refluxing segments and varicose reservoirs Objectives: Tocompare outcomesof endovenous microwave ablation (EMA) versus surgical stripping in the treatment of saphenous vein reflux. Patients and methods: In this retrospective analysis, 108 participants with primary varicose veins were categorized into two intervention groups. Group A (n=54) underwent conventional great saphenous vein stripping, whereas Group B (n=54) received EMA. Outcomes were monitored for 6 months. Results: The age of studied cases was 33.2±4.6 and 35.4±3.9 years in Groups A and B, respectively.  Post-operative (PO) discharge timelines mean was 2.8±0.6 days for group (A), whereas patients in group (B) were discharged after a mean time of 0.8 ±0.3 days. Two cases in group (A) experienced femoral vein hemorrhage. At 6-monthes post-operative follow-up; there were skin discoloration (pigmentation) noticed in 16 cases of group (A) and in only 2 cases of group (B), scarring was noticed only in group (A); and recurrence (Recanalization) was noticed only in group (B); The overall results were better in group (B). Conclusions: EMA of the Great saphenous vein (GSV) is a minimally invasive, efficient, and safe alternative, characterized by reduced complications, brief hospitalization, faster recovery, and rapid return to normal activities. Its cosmetic benefits make it an especially attractive option for female patients when compared to traditional surgical stripping.