The co - existence of lower extremity varicose veins and non - thrombotic iliac vein lesions is not uncommon in clinical practice. The clinical manifestations of the two are similar, but there is no linear correlation between their severity. Therefore, a thorough examination is required to individually analyze the causes of patients, and then formulate treatment strategies. Treating the two diseases simultaneously can resolve both superficial and deep venous issues, accelerate the improvement of clinical symptoms, especially the healing of venous ulcers. However, the overall cost is high, and there are issues such as exceeding medical insurance limits. Treating the two diseases in stages allows for a decision on whether to treat the other disease after close follow - up, but there is a risk of disease progression. This article reviewed the literature on the etiology, diagnosis, grading, and treatment of lower extremity varicose veins and non - thrombotic iliac vein lesions, and explored the optimal treatment strategies.