Objective: To compare the clinical effects of anterograde and retrograde invagination stripping for great saphenous varicose veins. Methods: The clinical data of 511 patients undergoing invagination stripping plus dot stripping for great saphenous varicose veins were retrospectively analyzed. Of the patients, 234 cases underwent stripping in an anterograde direction from the themedial malleolar region toward the saphenofemoral junction (anterograde stripping group) and 277 cases underwent stripping in a retrograde direction from the saphenofemoral junction toward the themedial malleolar region (retrograde stripping group). The main clinical variables between the two groups of patients were compared. Results: The preoperative data of the two groups of patients were comparable. There were no statistically significant differences in aspects of operative time, intraoperative blood loss, number of incisions, length of postoperative hospital stay, overall incidence of complications, postoperative leg acid bilges and ulcer healing time between the two groups (all P>0.05), but the incidence of saphenous nerve injury in the anterograde group recurrence rate of varicose veins in retrograde group in anterograde stripping group were significantly lower than those in retrograde stripping group (both P<0.05). Conclusion: For great saphenous varicose veins, anterograde stripping is superior to retrograde stripping in terms of reducing saphenous nerve injury and long-term efficacy.