ovarian vein coil embolisation is an effective and safe treatment for pelvic congestion syndrome and lower limb varices of pelvic origin. many patients with lower limb varices of pelvic origin respond to local treatment i.e. ultrasound guided sclerotherapy. in those cases, ovarian vein coil embolisation should be considered second line treatment to be used if veins recur in a short time period i.e. 1–3 years. this approach allows further pregnancies to proceed if desired. coil embolisation is not appropriate if a future pregnancy is possible. this treatment has largely superseded operative options.