Objective: To assess the effectiveness of preoperative compression hosiery in reducing blood loss during surgery for varicose veins and improving cosmetic results. Setting: Vascular Surgical Unit, Dudley Group of Hospitals NHS Trust, West Midlands, UK. Design: Randomized, single-blind, prospective, controlled trial. Patients: Thirty-nine patients with varicose veins in 50 legs. Intervention: Group A, the control group ( n = 19), were given compression stockings on the first postoperative day after the bandages were removed. Group B, the study group ( n = 20), used compression stocking 24 h before surgery as well as in the postoperative period. The surgical procedure was standardized. Main outcome measures: Blood loss, weight of veins removed, operation time and cosmetic result after 6 weeks. Results: In group B, patients were noted to have reduced blood loss, a shorter operation time and a greater weight of avulsed veins. Poor cosmetic results were recorded in group A. Conclusions: Preoperative emptying of veins by using a compression stocking is useful in reducing blood loss and improving the cosmetic result after routine varicose vein surgery.