Abstract：Objective To investigate the clinical efficacy of endovenous thermal ablation （EVTA） combined with foam sclerotherapy in the treatment of lower limb varicose veins. Methods A total of 64 patients with lower limb varicose veins treated in our hospital from January 2020 to November 2022 were selected and randomly divided into an observation group and a control group, with 32 cases in each group. The control group was treated with high ligation and stripping of the great saphenous vein, while the observation group received 980 nm laser EVTA combined with foam sclerotherapy. The venous clinical severity score （VCSS）, Aberdeen Varicose Vein Questionnaire （AVVQ） score, platelet count （PLT）, mean platelet volume （MPV）, as well as surgical outcomes and incidence of adverse reactions, were compared between the two groups before and after treatment. Results The VCSS, AVVQ scores, and levels of PLT and MPV in the observation group after treatment, along with surgical time, time to ambulation, and intraoperative blood loss, were all significantly better than those in the control group （t＝12.114, 11.885, 4.612, 15.015, 15.007, 6.518, 13.638, all P＜0.05）. The incidence of adverse reactions in the observation group was slightly lower than in the control group, but the difference was not statistically significant （χ2＝0.784, P＞0.05）. Conclusion EVTA combined with foam sclerotherapy can improve clinical symptoms and platelet levels in patients with lower limb varicose veins, reduce intraoperative blood loss and surgery time, and is associated with high treatment safety.