Chronic venous insufficiency has been known as a distinct pathologic entity at least since the time of Hippocrates, yet many pathologic features of this common ailment remain obscure. A recent resurgence of investigative effort in chronic venous insufficiency has occurred, spurred by the development of valve reconstruction surgery. The advent of newer diagnostic devices and techniques such as duplex scan and air plethysmography allow for a more detailed examination of the venous system than was possible previously.