BACKGROUNDTreatment of chronic venous disease and varicose veins has significant psychosocial and economic impact. The great saphenous vein is a common vein to develop incompetence and reflux and, therefore, been the focus of therapy for many years.OBJECTIVETo review the published medical literature relating to large varicose vein closure and provide a guide for closure techniques' efficacy and safety.METHODSA comprehensive search of the English language literature was performed up to and including December 2021. All references pertaining to large varicose vein closure were reviewed.RESULTSThere are multiple safe and effective minimally invasive methods to achieve occlusion of incompetent great saphenous vein, the most widely used of which is endovenous thermal ablation. Other nonthermal, tumescent, and nontumescent methods can also be used.CONCLUSIONProper knowledge of vein anatomy, ultrasound, and vein closure procedures is needed to ensure safe and effective outcomes.