Chronic venous insufficiency (CVI) typically refers to lower extremity edema, skin trophic changes, and discomfort secondary to venous hypertension. Chronic venous insufficiency is a prevalent disease process. Disability-related to chronic venous insufficiency attributes to diminished quality of life and loss of work productivity. In most cases, the cause is incompetent valves. Each year approximately 150,000 new patients are diagnosed with chronic venous insufficiency, and nearly $500 million is used in the care of these patients. If CVI is left untreated it is usually progressive and leads to the post-phlebitic syndrome and venous ulcers. Besides the cosmetic deficit, the patient may complain of pain, leg swelling, pruritus, and skin discoloration. The cornerstone of treatment is the use of compression stockings but compliance rates are poor. Many patients elect to undergo surgery and the outcomes do vary. The CEAP classification (clinical, etiology, anatomy, and pathophysiology) has been developed to guide decision-making in chronic venous insufficiency evaluation and treatment. The system has shown to predict the patient's quality of life and severity of their symptoms.