Background and Aims The hemodynamic types of lower limb varicose veins arising from non-saphenous tributaries are complex, and traditional treatment methods such as saphenous vein main trunk closure or stripping may miss reflux point, resulting in a high recurrence rate. Currently, commonly used treatment methods mainly include radiofrequency ablation (RFA), laser therapy, and foam sclerotherapy, but there has yet to be a consensus. This study aims to evaluate the safety and effectiveness of conservative hemodynamic correction of venous insufficiency (CHIVA) and RFA combined with ultrasound-guided foam sclerotherapy (UGFS) obliteration for non-saphenous varicose veins of the lower limbs.Methods A total of 95 patients with lower limb varicose veins originating from non-saphenous sources, who were consecutively admitted to Xiangya Third Hospital of Central South University and followed up regularly from July 2019 to December 2021, were selected. Among them, 41 patients underwent CHIVA treatment (CHIVA group), and 54 underwent RFA combined with UGFS obliteration (closure group). The data that included demographic characteristics, reflux vein types, shunt types, perioperative conditions, postoperative efficacy, complications, and Venous Clinical Severity Score (VCSS) were collected.Results The CHIVA group had a significantly shorter average operative time than that of the closure group (61.36 min vs. 78.15 min, P=0.000 5), significantly less average intraoperative blood loss than that of the closure group (4.07 mL vs. 8.52 mL, P<0.000 1), a and significantly fewer incisions during the operation than that of the closure group (1.58 vs. 3.65, P<0.000 1); there was no significant difference in average hospital stay between the two groups (P>0.05). The incidence rates of pigmentation, thrombophlebitis, and hematoma in the CHIVA group were significantly lower than those in the closure group (4.9% vs. 24.1%; 2.4% vs. 14.8%; 0 vs. 11.1%, all P<0.05). Six months after the operation, the varicose vein regression rate in the closure group was significantly higher than that in the CHIVA group (90.7% vs. 70.7%, P<0.05). The reintervention rate in the CHIVA group was significantly higher than that in the closure group (29.3% vs. 9.3%, P<0.05). There was no significant difference between the two groups regarding newly developed varicose veins 12 months after operation (P>0.05). Both groups showed significant improvement in VCSS at 6 and 12 months after operation compared to preoperative scores, but at 6 months after operation, the CHIVA group showed a more significant decrease compared with the closure group (1.89 vs. 2.50, P<0.05); there was no statistically significant difference in VCSS between the two groups at 12 months after operation (P>0.05).Conclusion Compared to obliteration therapy, CHIVA has similar outcomes in varicose vein regression and quality of life at postoperative 1 year, with better perioperative variables and fewer complications, but a higher demand for reintervention at postoperative 6 months. Both methods have comparable safety and effectiveness, and the specific choice should be based on the center's technical equipment, the surgeon's experience, and the patient's preferences.