Background: Varicose veins are a common vascular condition, often necessitating surgical intervention. One of the debated aspects of surgical management is whether to perform great saphenous vein (GSV) stripping in addition to other procedures. This study aims to compare the outcomes of surgical management of varicose veins with and without GSV stripping. Materials and Methods: A retrospective analysis was conducted on patients who underwent surgical management for varicose veins between January 2018 and December 2020 in Madhubani Medical College, Madhubani, Bihar, India. Patients were divided into two groups: those who underwent surgical intervention with GSV stripping (Group A) and those without GSV stripping (Group B). Data on patient demographics, perioperative complications, length of hospital stay, recurrence rates, and patient-reported outcomes were collected and analyzed. Results: A total of 200 patients were included in the study, with 100 patients in each group. In Group A, the mean length of hospital stay was 2.5 days (SD ± 0.8), compared to 2.8 days (SD ± 1.0) in Group B. Perioperative complications were observed in 8% of patients in Group A and 12% in Group B. Recurrence rates at one-year follow-up were 5% in Group A and 8% in Group B. Patient-reported outcomes indicated higher satisfaction levels in Group A compared to Group B. Conclusion: Surgical management of varicose veins with GSV stripping appears to be associated with shorter hospital stays, lower perioperative complication rates, and potentially lower recurrence rates compared to procedures without GSV stripping. Additionally, patients who underwent GSV stripping reported higher satisfaction levels. These findings suggest that GSV stripping may offer improved outcomes in the surgical management of varicose veins.