Preoperative treatment of the peripheral venous pathology in patients with indication for total knee arthroplasty (TKA) would reduce the risk of postoperative deep venous thrombosis (DVT). Between 1997 and 2004, 110 patients were evaluated for TKA. 35 had also varicose veins in the lower limbs. 4 patients were excluded because of absolute contraindications for surgery. 31 patients presented varicose disease, in different stages according with CEAP. The patients were treated surgically (Babcock or Muller technique), phlebotomy drugs and mechanical contention. In a single case the TKA was done without any preoperative treatment of the varicosities. TKA was done after 8-12 weeks. DVT prophylactic measures were undertaken in all 95 cases. Results were good except 2 cases of DVT and 1 case or pulmonary embolism in patients with preoperative treatment of the venous disease. The patient with no preoperative treatment of its varicose veins developed DVT with chronic, persistent oedema. Preoperative treatment of the varicose veins in the lower limb is mandatory for a successful TKA.