Late 2014 saw an interesting and clever addition to the treatment of large abnormal veins using medical glue (cyanoacrylate) with the introduction of the medical adhesive closure procedure. The available data from trials performed from large centres of excellence suggest that medical adhesive closure is as effective as Endovenous Laser Ablation (EVLA). Medical adhesive closure unlike EVLA does not use heat energy which means the whole procedure can be performed with one anaesthetic micro injection. The procedure involves the painless introductions of a small catheter through anaesthetised skin into the vein lumen and the accurate placement of medical glue inside the vein. Hand pressure is applied that bonds the vein wall together so there is no longer any blood flow in the abnormal vein. Medical glue has been used for over 50 years in various medical procedures and is very safe and effective.