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An ambulatory phlebectomy is a surgical procedure that removes bulging varicose veins on the legs. Veins that can be removed with this method include major tributaries; perforators; and reticular veins, including smaller veins associated with telangiectasias. Skin incisions or needle punctures as small as 1 mm are used to extract veins with a phlebectomy instrument. The procedure is well tolerated by patients and produces excellent cosmetic results. In contrast to sclerotherapy of large varicose veins, ambulatory phlebectomy minimizes the risks of intra-arterial injection, skin necrosis, and residual hyperpigmentation. In contrast to traditional venous ligation, the small size of the skin incision or puncture usually results in little or no scarring. The treatment is performed with the patient under local anesthesia and patients can walk immediately post-procedure.