The authors present surgical treatment of congenital hypoplasia of the common femoral vein. In this case, hypoplasia proceeded under the guise of secondary dilatation of great saphenous vein with initial manifestations of chronic venous insufficiency for a long time. Surgery for varicose veins in another hospital significantly worsened symptoms of venous insufficiency and quality of life. Surgeon did not perform Doppler ultrasound of the veins prior to surgery and considered previous ultrasonic data only. The patient finally underwent common femoral vein replacement with autologous venous conduit with subsequent regression of venous insufficiency. This case demonstrates an importance of Doppler ultrasound in preoperative examination. Moreover, an experienced specialist, preferably attending physician, should perform this procedure.