The use of endovenous procedures to eliminate saphenous and primary branch reflux has been growing exponentially over the last few years. Although initially developed by dermatologic surgeons, the technique has been embraced by many other specialties including radiology, vascular surgery and anesthesiology. Radiofrequency energy was the first used in 1999 for endovenous ablation. More recently, laser technology targeting hemoglobin (810 nm, 940 nm & 980 nm) and water (1320 nm) have been developed to quickly and effectively treat saphenous reflux, with minimal side effects. The placement of peri-vascular anesthesia, using the tumescent technique, has further streamlined these procedures. The purpose of this article is to review our experience and outline advantages and disadvantages of the various techniques available.