This paper highlights the topical problems of the management of female patients presenting with pelvic varicose veins in the absence of pelvic venous congestion. The sole symptom of the pelvic vein disease in these patients was vulvar varicosis. The surgical intervention on subcutaneous veins of the perineum and lower extremities was performed in 35 patients at the mean age of 29±3.7 years. Fifteen women presented with a combination of vulvar varicosis (n=13), dilated pubic veins (n=2), and primary varicosis of the lower extremities. Eight patients had varicose veins only in the perineum. The latent form of pelvic varicosis in combinations with varicose veins in the lower extremities was documented in 12 women. The treatment strategies to be applied in various clinical situations (including combined dilation of gonadal, pelvic, perineal, veins and subcutaneous leg veins of the lower extremities) are proposed. The late outcomes of surgical interventions on the subcutaneous veins in the patients presenting with pelvic varicosis are described.