In many western countries endovenous thermal ablation techniques have largely replaced classical surgery for the treatment of saphenous varicose veins as they are more effective and patient friendly. Because these treatments can be performed under local tumescent anaesthesia, patients can mobilize immediately after the procedure. A new method of thermal ablation is endovenous steam ablation, which is a fast and easy procedure. Steam ablation may cause less pain than laser ablation and it is also cheaper and more flexible than segmental radiofrequency ablation.