<p>Chronic deep venous insufficiency (CVI) of the lower extremities results from structural or functional abnormalities of the venous valves, leading to blood reflux and increased venous pressure. Common clinical manifestations include edema, varicose veins, skin hyperpigmentation, and ulcers. The primary etiologies of CVI include congenital valve defects and secondary damage from venous thrombosis, both of which significantly impair quality of life. Surgical treatments for CVI include valve repair, valve transposition, and valve transplantation. Valve repair is effective when the valve structure is relatively intact, as it restores function and improves venous return. However, its efficacy diminishes in cases of severe valve damage, and long-term follow-up is necessary. Valve transposition, which involves relocating a functional segment of the valve to a non-functional area, is technically challenging and carries a higher risk of complications. Valve transplantation, in which veins from other parts of the body are used, is indicated for extensive valve damage but is constrained by the limited availability of donor veins and the technical complexity of the procedure. The selection of an appropriate surgical method should be based on a comprehensive assessment of the patient’s condition.This manuscript presents a unique case of successful femoral vein valve repair combined with deep femoral vein ligation in a patient with CVI and aneurysmal dilation, highlighting an effective treatment approach for femoral and deep femoral vein reflux. The case offers valuable insights into the management of CVI, particularly in complex cases where conventional treatments may be less effective.</p>