To review the available data of randomized controlled clinical trials (RCT) to compare endovenous laser therapy (EVLT) with conventional surgery of high ligation and stripping (HL/S) for the treatment of great saphenous varicose veins. A systematic review of Pubmed, Cochrane Library, Embase, Web of Science, Ovid database, China National Knowledge Infrastructure (CNKI) database and Wanfang database was performed to retrieve RCT studies on the effectiveness of EVLT versus HL/S up to January 1999. The rates of postoperative recurrence at 1 year, 2 years and major complications were analyzed by Review Manager 5.1 software. Eight retrieved RCT studies and 1743 limps were evaluated. The ratios of recurrence were the same for EVLT and HL/S at 1 and 2 years post-operation. For the ratios of major postoperative complications, there was no statistical difference between EVLT and HL/S in thrombosis, wound infection and phlebitis. But EVLT could reduce the ratio of paresthesia. Compared with HL/S, EVLT shows no significant difference in the 1/2-year recurrence rate or the rates of thrombosis, wound infection and phlebitis. However, it can decrease the rate of paresthesia.