Endovenous laser ablation (EVLA) has become a mainstay treatment for superficial venous insufficiency, traditionally employing laser wavelengths in the range of 810 nm to 1470 nm. In recent years, however, higher-wavelength laser systems (>1900 nm) have been introduced, with the goal of optimizing energy absorption in water and reducing collateral tissue damage. This systematic review evaluates the current literature on endovenous laser ablation with laser wavelengths above 1900 nm, focusing on efficacy, safety, and procedural outcomes. We discuss the theoretical advantages of higher-wavelength lasers, such as improved vein closure rates and reduced postoperative pain, alongside the existing clinical evidence. By synthesizing available data, this review aims to guide clinicians considering the adoption of 1900+ nm laser systems and to highlight areas where additional research is needed.

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