Aim. To estimate the effectiveness of endovenous laser ablation of primary varicose veins in the lower extremities of the patients presenting with crural trophic ulcers. Material and methods. We analysed the results of the treatment of 34 patients presenting with primary varicose veins of the functioncal classes C2—C6 in the lower extremities. The mean age of the patients was 43 years, most of them were women (76%). Pathological reflux in the trunks of saphenous veins and in perforating veins was eliminated either by means of miniphlebectomy or using sclerotherapy. A total of 43 ablations of the trunks of saphenous veins and 39 ablations of perforating veins were performed. In 9 patients, the diameter of the trunks of great and small saphenous veins exceeded 1 cm, the maximum diameter amounted to 16.9 mm.  The maximum diameter of an incompetent perforating vein was 16.9 mm. Results. The control examination by ultrasound angioscanning (USAS) within one year after EVLA confirmed obliteration of 95% of the treated trunks and 100% of the perforating veins. In two (5%) cases, laser ablation of the great saphenous vein up to the upper third of the lower leg resulted in trunk recanalization. No complications, such as suppuration, hemorrhage, deep venous thrombosis, and laser burns were documented. Endovenous laser ablation resulted in the highly effective elimination of the symptoms of the disease in all the patients regardless of its clinical class. Conclusion. EVLA of the trunks of saphenous veins and of perforating veins supplemented by miniphlebectomy or sclerotherapy of varicose vein tributaries can be recommended as the highly efficacious method for the treatment of varicose vein disease including that in the patients with both the closed and open trophic ulcers. Nevertheless, the high probability of recanalization of venous trunks with a diameter more than 1 cm should be borne in mind.