Proper diagnosis is the key to proper treatment. One in three of our patients has had treatment at another facility. Ineffective treatments are usually results of improper or insufficient diagnosis or just visual diagnosis. Varicose veins require the most precise vascular ultrasound and needs to be performed by someone with considerable clinical experience. The results of the diagnostic test drives the treatment plan. A poor ultrasound = a poor treatment plan. We pay great attention to the ultrasound exam – a cornerstone in the diagnosis of varicose vein disease. The proper examination should evaluate the deep system for for obstruction and for deep venous insufficiency. The superficial system should be evaluated for venous insufficiency and every vein should be evaluated in its entirety. Modern ultrasound machines allow the differentiation of segments with poor venous valves and reverse flow (venous reflux), often at a very early stage. If the ultrasound specialist does not have enough experience he/she can omit "bad" veins supply points, or vice versa choose the vein that does not need to be treated. Ultrasound study in expert hands provides indispensable information about the superficial and deep veins, and the presence and extent of abnormal flow – the true causes of your disease.