The Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society recently released the 2023 clinical practice guidelines for the management of varicose veins of the lower extremities, and provided new evidence-based recommendations on key issues affecting the management of patients with lower extremity varicose veins (CEAP class 2 diseases). The main content of the guidelines includes evidence-based recommendations for patients with lower extremity varicose veins in terms of clinical evaluation, compression therapy, medications and nutritional supplements, endovenous ablation versus high ligation and stripping for saphenous vein reflux, evaluation and treatment of varicose tributaries and incompetent perforators, management of thrombotic complications, and management and treatment of bleeding varicose veins and superficial vein aneurysms. This article summarizes and interprets the key updates in the new guidelines, integrating the latest advances in evidence-based medicine, aiming to serve as a reference for the clinical practice of domestic counterparts.