Introduction: Endovenous laser ablation (EVLA) of the saphenous vein has almost completely replaced surgical stripping for the treatment of saphenous vein reflux. In contrast to stripping that includes phlebectomy, EVLA is generally performed in two stages; ablation followed, when needed, by phlebectomy or sclerotherapy for branch varicose veins. However, there are several cosmetic complications after phlebectomy or sclerotherapy, such as surgical scar, haemorrhage and superficial thrombophlebitis. In our institution, a strategy is initiated to perform EVLA procedure without concomitant phlebectomy or sclerotherapy and to subsequently treat residual visible varicose veins with foam sclerotherapy if there are patients' request. This study assessed the efficacy of EVLA alone as a treatment for varicose veins. Methods: Patients undergoing EVLA alone (Radial 2Ring Fiber, ELVeS) as an initial treatment for varicose veins between September 2014 and December 2018 were enrolled. The clinical severity of venous insufficiency was graded according to CEAP classification. Patients were examined with duplex ultrasound imaging at two days, one month and one year after EVLA. Results: Seven hundred sixty-five limbs in 612 patients were included (400 females, 212 males, mean age 62 ± 13 years). Average follow-up time was 272 ± 8 days. By CEAP classification, 170 limbs were C2 (22.2 %), 348 were C3 (45.5 %), 220 were C4 (28.8 %), 10 were C5 (1.3 %) and 17 were C6 (2.2 %). Great saphenous veins (GSV) were treated in 624 extremities (81.6 %) and small saphenous veins (SSV) were treated in 141 (18.4 %) extremities. The mean diameter of GSV and SSV were 7.2 ± 0.1 mm and 6.0 ± 0.1 mm, respectively. The mean vein treatment length of GSV and SSV were 40.8 ± 0.3 cm and 16.6 ± 0.5 cm, respectively. A mean linear endovenous energy density was 57 ± 0.5 J/cm. There were no major complications such as pulmonary embolism or deep vein thrombosis. Concerning endovenous heat-induced thrombus (EHIT), class 1 were observed in 18 patients, class 2 in 26 patients and class 3 in seven patients, but no class 4. After EVLA, the rate of recanalization was 4.3%. Additional foam sclerotherapy for residual branch varicose veins was needed in 51 limbs (6.7%) for cosmetic reason. The mean time between initial treatment and subsequent procedure was 268 ± 33 days. Predictor of sclerotherapy after EVLA alone by multivariate analysis was female. Conclusion: After EVLA, only 6.7% of extremities required further treatment. Our results suggest that EVLA alone for the insufficient saphenous vein can result in improvement of symptoms and regression of visible varicosities, and the majority of patients undertaken EVLA alone might be spared unnecessary phlebectomy or sclerotherapy. Disclosure: Nothing to disclose