Varicose veins are a prevalent manifestation of chronic venous disease (CVD) and a significant source of morbidity and healthcare costs globally. Historically, surgical ligation and stripping were the mainstay treatments. However, the past two decades have seen the rise of minimally invasive interventions such as endovenous thermal ablation (laser or radiofrequency), sclerotherapy (foam or liquid), and non-thermal, non-tumescent techniques (cyanoacrylate closure, mechanochemical ablation). These procedures differ not only in clinical outcomes—like vein closure rates and patient satisfaction—but also in cost profiles, resource utilization, and cost-effectiveness. This comprehensive review explores the economic burden of varicose veins and analyzes the cost-effectiveness of contemporary treatment options. By synthesizing the available literature and economic studies, this review provides valuable insights for clinicians, policymakers, and payers involved in managing venous disease. The article highlights key methodologies for cost-effectiveness analysis, compares direct and indirect costs, and discusses how different healthcare settings influence cost evaluations. While most interventions have demonstrated favorable cost-effectiveness relative to surgery, nuances remain in areas such as long-term recurrence, the influence of patient comorbidities, and evolving device costs.

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