Introduction: Interventional treatment of superficial venous incompetence can be accomplished by techniques that result in removal, ablation, or ligation of the refluxing venous segment. Current options include high ligation, ligation and stripping, endovascular ablation, sclerotherapy, and phlebectomy. The detailed duplex studies of Labropoulos and others challenged this theory and supported an “ascending” cause of varicose veins, which is initiated in the “distal superficial venous network.” [1] . Two groups of procedures accomplish this approach: CHIVA (Cure Conservatrice et hemodynamique de l’Isuffisance Veineuse en Ambulatoire) and ASVAL (Ambulatory Selective varices Ablation) techniques [2] . Patients and Methods: Fifty six (56) patients who had been referred to the vascular outpatient clinic of our department at Kasralainy teaching hospitals for management of their chronic venous insufficiency (CVI ) in the period between july 2014 to December 2015. Patients presenting with CVI of the great saphenous vein (GSV) were randomized and treated with stripping or CHIVA. Patients were consented to follow up over an extended period in order to detect recurrence during 1 year period following treatment. Results: Thirty patients were treated with CHIVA technique and 26 were treated by trendelenberg and stripping. Both Hobb’s objective score and subjective score differences between CHIVA and stripping at 1, 3 and 6 were not statistically significant , but was significant at 12 months (p value 0.0242) and (p value 0.0171) respectively. Five patients of the CHIVA group had subjective score 3 all of which recurrences were confirmed by duplex study. Only one patient in the stripping group had 3 which did not correlate clinically with the objective score or by duplex examination. There was no recurrence in the stripping group. There were different patterns of recurrence in the CHIVA group. Conclusion: Haemodynamic surgery for the treatment of varicose veins has been highly debated and frequently rejected because of being remote from traditional surgery. CHIVA is safe and effective in the treatment of varicose veins in addition to preserving the GSV for drainage and being less surgically invasive. Nevertheless, the CHIVA cure demands significant training, principally in hemodynamic concepts, since the identification of shunts and technical aspects of a CHIVA intervention require a great deal of precision to produce good results. Nevertheless if that knowledge and training are not acquired, a properly executed stripping intervention is better than a poorly executed CHIVA intervention, both regarding strategic goals and surgical execution. Duplex documented recurrence is much higher in CHIVA group as compared to stripping group on the short term (1 year). Patterns of recurrence in CHIVA are easily managed by phlebectomy or foam injection CHIVA oriented sclerotherapy. Keywords: stripping , hemodynamic venous surgery , nonablative treatment of varicose veins , CHIVA.