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This chapter reviews the history of Foam sclerotherapy (FS) and discusses the currently available sclerosants and techniques. It presents the results of FS from large observational and randomized studies and suggests how FS might fit within a multimodality endovenous treatment offer and provides some recommendations regarding further research. In Europe, most phlebologists use “home-made” sodium tetradecyl sulfate and/or polidocanol microfoam for FS. FS is particularly appropriate for complex recurrent disease associated with neovascularization, where the varicose veins (VV) to be treated are often too small, tortuous, and superficial to be treated easily by means of endothermal ablation and where the versatility and adaptability of FS is a major advantage. The phlebologist has a wide variety of endovenous techniques to treat VVs, and these can be combined in imaginative ways so that the overall treatment offer is tailored to the individual patient’s needs, expectations, and desires.