Aim. To evaluate the effectiveness of laser endoscopic coagulation used to treat crural perforating veins in comparison with endoscopic dissection. Material and methods. Four series of experiments were carried out to determine the optimal regime of extravasal treatment at a laser radiation wavelength of 1064 nm per vein. Retrospective analysis of the results of laser therapy involved 62 patients presenting with primary varicosis (25 with class C4 varicose veins, 23 with C5, and 14 with C6 disorders). The patients of the study group (n=32) underwent video-assisted subfascial laser obliteration of crural perforating veins during phlebectomy, those of the control group (n=30) were treated by subfascial endoscopic dissection. The two groups were matched for age, gender, severity of the disease, and peculiarities of pathological reflux. Results.The results of this experimental study allowed the optimal regime of laser irradiation of the venous wall to be chosen, namely 20 W for 2-4 s. The mean duration of laser coagulation and endoscopic dissection was 12±1.5 and 20±3.5 min respectively (p<0.05); pain intensity in the postoperative period was estimated as 3.4 and 6.2 on the average based on a visual-analogous scale (p<0.05); the frequency of development of subfascial hematomas was 2/6 and 6/20%, that of paresthesia 5/16 and 7/23% respectively (p>0.05); mean hospital bed-day 5.7 and 6.9 (p>0.05). Conclusion. Video-assisted subfascial laser obliteration of compromised crural perforating veins can be used in the combined surgical treatment of the patients suffering trophic disorders.