Venous obliteration using foam sclerosant is a relatively new procedure that holds great promise and may prove to be as effective as conventional surgical treatments in obliteration of the great saphenous vein. Foam sclerotherapy can have minor and major complications, most of which occur as a result of gas or sclerosant leakage into the systemic venous system. Conventionally, the saphenofemoral junction is occluded by digital pressure to prevent escape of sclerosant foam into the deep venous system. We propose balloon control of the saphenofemoral junction to prevent sclerosant leakage. This also promotes foam contact with the endothelium in a prolonged, controlled fashion. This method requires no anesthesia, is suitable for ambulatory care, and has been safe and successful in all five cases. Duplex examinations at 1 week and 3 months have shown complete obliteration of the great saphenous vein using this technique.