This study was designed to compare two methods for the treatment of incompetent small and great saphenous veins and elimination of vertical veno-venous reflux in patients presenting with class C2-C6 primary varicosis. The radiofrequency ablation (RA) and ultrasound-guided foam sclerotherapy (UGFS) were applied to treat 145 and 1059 saphenous trunks respectively. The treatment was done on an outpatient basis. It was shown that the latter method (UGFS) had more limitations, more frequently produced adverse effects, and required a longer period of elastic compression thereby being less comfortable for the patients than the radiofrequency ablation. However, RA had the disadvantage of being more expensive. At the same time, the analysis of its immediate results has demonstrated occlusion of 100% of the saphenous trunks in the absence of deep venous thrombosis. Ultrasound-guided foam sclerotherapy resulted in the occlusion of 98.8 and 97.6% of great and small saphenous veins respectively. The frequency of deep thrombosis of these vessels was 0.5 and 2.4% respectively. The follow-up assessment of up to 3 years revealed occlusion of 100% of the saphenous trunks after radiofrequency obliteration. The use of this technique resulted in the occlusion of 93.3 and 90.9% of great and small saphenous veins respectively. The results of the study indicate that radiofrequency obliteration of incompetent saphenous trunks should be preferred over ultrasound-guided foam sclerotherapy as the method of treatment of vertical veno-venous reflux.