Aim. To estimate the effectiveness of the application of laser-assisted technologies in combination with microfoam sclerotherapy for the treatment of the patients presenting with severe chronic venous insufficiency and trophic disorders. Material and methods. We have undertaken the retrospective analysis of standard crossectomy, stripping, and ligation of incompetent crural perforating veins from various approaches in 220 patients of the first group (126 patients with functional class C4 disease, 52 with C5, 42 with C6) and endovenous laser ablation in combination with microfoam scleropathy in 271 patients of the second group (146 patients with functional class C4 disease, 73 with C5, 52 with C6). Al the patients were examined in the preoperative period by duplex scanning of the lower extremities. Results. The symptoms of venous eczema were eliminated in all the patients of the first group. Healing of trophic wounds within 6 months after the onset of the treatment was documented in 40 (95%) patients. Twelve patients with C5, C6 exhibited postoperative hematomas on the lower legs, 5 patients presented with inguinal lymphorrhea in the region of the postoperative wound. In 267 (98.5%) patients of the second group, obliteration of the trunks of the great and small saphenous veins was achieved without additional procedures. Repeated ablation of the trunk of the great saphenous vein on the thigh and of incompetent crural perforating veins within 2 months after the primary treatment was needed in 4 (1.5%) patients and 9 (3.3%) ones respectively. The symptoms of venous eczema were eliminated in all the patients of the second group. The closure of trophic wounds was documented in 49 patients of the second group with C6 disease (94%); in another 3 (6%) patients with the extensive trophic wounds their area significantly reduced. Conclusion. Endovenous laser ablation of the trunks of saphenous veins and of perforating veins in combination with microfoam sclerotherapy of their subcutaneous tributaries may be regarded as low-traumatic interventions allowing to  eliminate pathological reflux and avoid postoperative complications.