Surgery for varicose veins is a common surgical procedure performed for various indications including cosmesis. Patient satisfaction with the eventual outcome is therefore important. A total of 311 patients (68%), who underwent varicose vein surgery during a 10-year period, replied to a postal survey of 456 patients [National Health Service (NHS) 327: private patients (PP) 129]. Of those 311, 19% of the NHS patients compared with 34% of the PP were completely satisfied with the surgery, the communication and had had no post-operative complications (P < 0.01). Twenty-six per cent of the NHS patients were very dissatisfied with their treatment compared with 13% of the PP (P < 0.025). The majority of dissatisfied patients were female (P < 0.005). These results suggest that while varicose vein surgery is regarded as a safe and often minor procedure, it is associated with a significant surgical morbidity and patient dissatisfaction. Patients should be made aware of the potential outcome prior to surgery.