BACKGROUND. Appropriate management of venous disease requires definiti
ve diagnosis. The place of phlebography and varicography in acute and
chronic venous disease is to complement other less invasive and less e
xpensive tests of venous function. OBJECTIVE. This paper will address
the present indications for phlebography and present the techniques of
ascending and descending phlebography and of varicography practiced i
n our environment. METHODS. The technique of each type of phlebography
are outlined. These include ascending phlebography at the foot, popli
teal and femoral levels, varicography, and descending phlebography. Co
mplications are discussed briefly. RESULTS. The advantages and complic
ations of each method are discussed with the description of the proced
ures. CONCLUSION. The most frequent uses of phlebography in acute veno
us thrombosis are to define deep vein thrombosis isolated to the calf
or to the iliac veins, or to clarify findings from duplex scan examina
tions. In chronic venous disease, phlebography is used to clarify prob
lem cases of superficial venous disease and to study patients with adv
anced deep vein disease who are potential candidates for deep vein rec
onstruction.