Background: Patients with chronic venous insufficiency (CVI) undergo a standard puncture below the knee to access the great saphenous vein (GSV) for endovenous laser ablation (EVLA). However, in some cases, getting a puncture below the knee is difficult; a puncture above the knee to access the incompetent saphenous vein is another option. Objective: This study compared CVI patients' clinical results after EVLA with below- and above-the-knee punctures. Material and Methods: This retrospective, single-centre cohort study compared clinical outcomes after two EVLA technical punctures (puncturing the GSV below- and above-knee). At all follow-up visits, clinical outcomes, closure rate, and complications were assessed. Result: This study has recruited 248 patients, with 132 patients in the below-knee group and 116 patients in the above-knee group. Similar clinical outcomes after the procedure were seen in both groups with improving of the Venous Clinical Severity Score (VCSS) and the Venous Disability Score (VDS) (p < 0.05). The closure rate in both groups was 97% (p = 0.595). Complications, including thrombosis, bruises and paresthesia did not show statistical significance between groups (p = 1.000, p = 0.101 and p = 0.667 respectively). Burn injury was absent in both groups. Conclusion: The EVLA for incompetence GSV using an above-knee puncture was safe and effective and should be considered as an alternative method if the below-knee puncture fails in Non Ulcer CVI patients. Keyword: Chronic Venous Insufficiency, Endovenous Laser Ablation, Great Saphenous Vein.