Blind dissection of incompetent perforators is common practice for vein surgeons. Since many years some of them have been trying to do this endoscopically by means of the proctoscope or other endoscopes used for different purposes. At present however several surgeons are developing special instruments for this type of endoscopy. Lately some of these surgeons came together to work up their experiences and to study the probable future of the method. It permits the diagnosis and at the same time the treatment of incompetent perforators. It allows the healthy ones to be spared. All this can be done from a small incision distant to the site of the perforators where the skin often presents with trophic changes. However general or regional anesthesia as well as the bloodless limb technique are prerequisites. As any endoscopy also this one has its specific dangers and complications and therefore has to be learned and performed carefully.