Phenotypic transformation of the vascular smooth muscle cells (VSMCs) is considered the cytological basis of vascular remodeling. VSMCs with contractile phenotype and synthesis phenotype exhibit different functions, and they can transform to each other reciprocally. Here, the authors review and extract the research progress in terms of the concept and characteristics of phenotypic transformation, phenotype markers, and proliferation and migration of the VSMCs derived from the great saphenous vein, as well as the relation of the matrix metalloproteinases and their inhibitors, apoptosis, and epigenetic factors with their phenotypic transformation, so as to provide a theoretical foundation for screening the drug targets associated with prevention and treatment of varicose veins.