Objective: Lower limb pain as a symptom in patients with varicose veins is non-specific, varies in intensity from patient to patient, and may have various causes. In this retrospective study, we examined the incidence of leg pain in our outpatient clinic and how it may be related to CEAP class and comorbidities. Methods: 405 patients (106 men and 299 women; age range 19–98 years; mean age 61±SD years) entered our study. Lower limb pain was assessed in an interview conducted by an MD trained in phlebology and Duplex Ultrasound examination was performed on all patients. Results: Pain was the third cause of vascular consultation (51 patients, 12.6%). Pain incidence was significant in CEAP class C0 (26 patients, p<0.001) and in CEAP class C6 (10 patients, p<0.001), but not in CEAP class C2 (43/199 patients, p=0.025) where occurred more frequently in women (38 patients, p=0.024), and mainly caused by superficial phlebitis. Also in CEAP class C3 (15/100 patients, p=0.002) pain incidence was not significant; it’s worth noting that orthopedic and muscolo-skeletal diseases as possible cause were frequently present. Conclusion In our experience, pain as symptom in varicose veins (CEAP class C2 and C3) was non-significant; careful clinical examination to clarify the meaning of pain relative to venous disease is mandatory before surgery and a multidisciplnary approach is recommended.