Aim — the objective of the present study was to evaluate the effectiveness and safety of micronized purified flavonoid fraction (MPFF) for the treatment of the patients presenting with concomitant varicose veins of the pelvis (PVV) and lower limbs (VVLL). Material and methods. The study included a total of 65 patients suffering from combined VVP and VVLL. They were divided into two groups. Group 1 was comprised of 35 women with chronic pelvic pain of less than 5 scores based on the visual analog scale (VAS). They received MPFF at a dose of 1000 mg once daily for 2 months. In the group 2 (30 patients) presenting with chronic pelvic pain of more than 5 VAS scores, MPFF was prescribed first at a dose of 1000 mg twice daily for 1 month, then 1000 mg once daily for another 1 month. The primary end-point were chronic pelvic pain (CPP) and venous pain in the lower extremities before the inclusion in the study and 2 months after the onset of therapy. All the patients were examined with the use of duplex ultrasound of the pelvic and lower limb veins, radionuclide phlebography (RPG) of lower extremities, and pelvic vein scintigraphy. Results. After 1 month of the treatment, the severity of the pain syndrome in all the patients of group 1 decreased almost 2-fold. After 2 months, CPP decreased from 3.4±1.2 to 0.83±0.18 (p=0.037). Venous pain in the lower extremities significantly decreased in 28 patients (from 2.8±0.6 to 0.94±0.11 after 2 months; p=0.003). The efficacy of the treatment was also confirmed by radionuclide and ultrasound studies. In group 2, the increased dosage of MPFF given during 1 month and followed by a standard dose of 1000 mg/day led to a decrease of pelvic pain intensity from 6.3±0.8 to 1.2±0.12 (p=0.001) and of perineal pain from 3.6±0.9 to 0.88±0.22 (p=0.004) while venous pain intensity in the lower extremities decreased from 4.6±0.5 to 0.92±0.14 (p=0.001). The results of the duplex ultrasound study and radionuclide phlebography gave evidence of the improvement of the hemodynamic parameters. Two patients in this group had adverse events (gastralgia). Conclusion. The treatment with the micronized purified flavonoid fraction provides the effective and safe tool for the management of the patients presenting with concomitant varicose veins of the pelvis and lower extremities.