Objective. The reduction of the symptoms associated with chronic venous insufficiency remains the main goal of conventional or endovenous varicose vein ablation. Our prospective study was designed to compare quality-of-life outcomes following endovenous laser treatment and surgery using venous clinical severity score (VCSS). Methods. Between September 2009 and April 2011, 112 patient underwent saphenous vein surgery (56 laser ablation and 56 traditional surgery procedure). In both nonrandomized groups, preoperative VCSS were documented and clinical and duplex examinations were performed at 7 days, 4 weeks and 6 months after procedure. VCSS scoring was repeated at follow-up visits. Results. Preoperative, 7 days, 4 weeks and 6 months VCSS scores were, respectively, 8,2 +- 2,3 in 56 limbs, 5,9 +- 2,0 in 51 limbs, 5,5 +- 2,1 in 45 limbs and 3,4 +- 1,5 in 42 limbs in surgery group. Preoperative, 7 days, 4 weeks and 6 months VCSS scores were, respectively 8,1 +- 2,5 in 56 limbs, 4,9 +- 2,1 in 54 limbs, 3,9 +- 1,9 in 49 limbs and 3,2 +- 1,4 in 48 limbs in endovenous group. VCSS scores were significantly better in the EVLT group at 7 days and at 4 weeks (P < 0,001). At 12 weeks, no significant differences were evident between the groups. Conclusion. Treatment of saphenous vein reflex with both types of procedure results in clinical improvement of symptoms. In the early postoperative period, endovenous laser therapy removes quality-of-life limitations of the traditional surgery. We found VCSS to be a good tool for assessing outcomes after varicose vein procedures.