Lower extremity venous disease can be classified by anatomic location, deep or superficial and by pathology, obstruction and reflux. Acute deep vein thrombosis (DVT) and superficial vein thrombosis (SVT) represent the most recognized diseases, but symptomatic chronic venous insufficiency (CVI) affects more than 20% of the population and is the most common cause of skin ulcers which may affect 0.5-1.4% of the Western population (1,2). One-third of patients with CVI have a history of DVT (1). Nearly 10% of the population may suffer from varicose veins (2). With an increasing array of potential interventional and non-interventional treatment options for venous disease, patients should undergo a thorough and systematic evaluation to provide the best improvement in quality of life and patient specific outcomes.