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The authors used a prospective study of 309 great saphenous veins to analyse, by Doppler and ultrasonography, the mechanism of sclerosis following sclerosing injections. These were administered at a maximum of 50mm from the sapheno-femoral junction using a protocol based upon five sessions. It was found possible to establish a close relationship between the quality of results and small calibre. Similarly, recurrence by early repermeation was generally secondary to a sclerosing reaction having caused thrombosis. Other changes were seen during or at the end of treatment, sometimes differing greatly from clinical findings. This type of sclerosing injection therapy provided more than 90% favourable responses to treatment after a follow-up period of 15.7 months. Analysis of other parameters may possibly enable even better definition of the treatment of this condition and its natural history.