The aim of this study was to investigate the efficacy and safety of endovenous laser ablation (EVLA) for treating insufficiency of the saphenous veins or accessory saphenous veins using a 1319-nm Nd:YAG pulse wave laser. Forty-nine patients (76 limbs, 87 veins, 53 cases) were retrospectively evaluated. Patients were elected to undergo EVLA for one of the three reasons: larger mean vein diameter (>10 mm), currently receiving anticoagulant/antiplatelet therapy, and/or patient request for a painless procedure. Sixty-two great saphenous veins (mean diameter, 9.6±3.7 mm), 21 short saphenous veins (mean diameter, 6.4±1.7 mm), and 4 other veins were ablated. No major complications such as deep vein thrombosis and paresthesia occurred. Postoperative pain and bruising were observed in 5.3% and 6.6% of limbs, respectively. All patients completed a 1-year follow-up. Occlusion of treated varicose veins was satisfactory except for one case of partial recanalization (1.2%). EVLA of varicose veins using a 1319-nm pulse laser is highly effective and associated with few side effects.