Background: An easy, effective, inexpensive, and aesthetic method of varicose vein avulsion, in an office setting, is the aim of most phlebologists. Muller's ambulatory phlebectomy probably comes very close to this goal. With the acceptance and diffusion of this method, imitations, deviations, and "ameliorations" are frequent but do not always represent a true evolution.
Objective: To describe the basic principles of the method and the evolution of some aspects (anesthesia, instruments, duplex mapping, eco-phlebectomy, compression) leading to effective advantages.
Conclusion: In its 40 years in existence, ambulatory phlebectomy has not significantly changed, and has proved to be easy and safe. The most important progress has been made in anesthetic dose and in ultrasound applications.