Twelve patients referred to a general surgeon with special interest in varicose veins were found to have vulval varices. All the patients were considered to be suffering from the pelvic congestion syndrome. Their radiological investigation by percutaneous vulval phlebography is described. It is suggested that patients with vulval varices should be examined radiologically by percutaneous vulval vein injection of contrast medium. It is postulated that pelvic vein thrombosis may precipitate the pelvic congestion syndrome. Whereas there is no established treatment of this syndrome, the radiological examination has proved helpful in planning the treatment of these patients.