Objective To investigate the efficacy of local injection of foam sclerosing agent, polidocanol, combined with high ligation and stripping of the great saphenous vein and observe the incidence of complications in patients with great saphenous vein varicosity complicated with elevated D-dimer level. Methods A retrospective analysis was performed on the clinical data of 838 patients with varicose saphenous veins admitted to the Department of Vascular Surgery of Weifang People′s Hospital from March 2020 to February 2021. Then from them, 66 patients with elevated preoperative D-dimer level were selected and assigned into the study group, and another 66 patients with normal D-dimer level preoperatively were subjected into the control group. All of them received high ligation and stripping of the great saphenous vein+varicose vein injection of polidocanol. The therapeutic effect and the occurrence of common phlebitis, superficial thrombophlebitis, deep vein thrombosis and other complications were observed in the two groups after operation. SPSS statistics 19.0 was used to perform the statistical analysis. Student′s t test or Chi-square test was employed for intergroup compa-rison depending on different data types. Results The CEAP scores [CEAP classification stands for Clinical (C), Etiology (E), Anatomy (A), and Pathology (P)] were compared between before treatment and 1 month after surgery [study group:(2.86±1.02) vs (0.97±1.48)points; control group:(2.80±1.13) vs (0.92±1.49) points], the differences were statistically significant (all P＜0.05). But there were no statistical differences in the CEAP scores between the two groups 1 month after surgery (P>0.05), and no significant differences in the incidence of complications between the study group and control group (59.1% vs 53.0%) (P>0.05). Conclusion Local injection of polidocanol combined with high ligation and stripping of the great saphenous vein is a safe and feasible treatment for varicose veins complicated with elevated D-dimer.