Objective To study the effect of radiofrequency ablation (RFA) of the great saphenous vein combined with foam sclerosant perfusion on perioperative indicators and recurrence rate in patients with venous leg ulcer (VLUE). Methods Retrospectively collect the clinical data of 80 VLUE patients treated in our hospital from June 2021 to June 2023. Among them, 40 patients treated with stripping of the great saphenous vein + foam sclerosant perfusion were selected as the control group, and 40 patients treated with RFA + foam sclerosant perfusion were selected as the study group. Clinical efficacy, surgical indexes, pre- and post-surgical blood related test indicators [fibrinogen activator inhibitor (PAI-1), fibrinogen (Fib), D-dimer (D-D)], ulcer status, pain scores, quality of life, complications and recurrence rates were compared between the two groups. Results The total effective rate of the study group (92.50%) was higher than that of the control group (75.00%)(P<0.05). Compared with the control group, the study group had shorter hospitalization time, operation time, and less bleeding volume (P<0.05). Three days after surgery, the study group"s indicators PAI-1, D-D, and Fib were lower than those in the control group (P<0.05). At 4 weeks after surgery, the ulcer status, pain level, and quality of life in the study group were better than those in the control group (P<0.05). There was no significant difference in the recurrence rate (2.50% vs 7.50%) and complication rate (5.00% vs 7.50%) between the two groups (P>0.05).