Background: Endovenous, open surgery or hybrid treatment are commonly performed methods of treatment for varicose veins. Comparative study between triple saphenectomy, Endovenous laser ablation (EVLA) and Endovenous Chemical Ablation with Trendelenburg's operation (eCAT) for treatment of primary varicose veins as regard, the return to daily activity, residual varicosities, complications, GSV caliber and, recurrence after one year. Patient and methods: Seventy five patients with primary varicose veins presented at AL-Azhar University hospital of New Damietta city during the period from November 2016 to December 2018. All patients were randomized into three equal groups each included 25 patients. Group I was treated by triple saphenectomy, group II was treated by EVLA, while group III was treated by eCAT. Results: Return to daily activity was more rapid in group II than that of group I and group III. Statistically significant results had been detected in patients with group III as regard reduced incidence of saphenous nerve injury, residual varicosities, recurrence together with early ecchymosis and hematoma formation. Saphenous nerve injury had been detected in 5 and 2 patients for group I, II respectively but not in group III. Residual varicosities were detected in 10,15,5 patients for group I, II and III respectively. Conclusion: Endovenous chemical ablation with Trendelenburg's operation had better results than endovenous laser ablation and triple saphenectomy as regard saphenous nerve injury, residual varicosities and recurrence with lower incidence of postoperative ecchymosis and hematoma formation.