Background: The ratio of volume flow in the common femoral vein and artery denoted as venous-arterial Flowindex (VAFI) is significantly increased in venous insufficiency according the clinical grade of the disease. This study was done to investigate the reliability and reproducibility of VAFI as quantitative pattern. Patients and methods: In 43 patients with varicose veins C(4-6)E(P)A(S,D,P)P(R) (PVV), 40 with postthrombotic syndrome C4-6 E A(S,D,P)P(R,O) (PTS) and 48 healthy volunteers volume flow in the common femoral vein (VFV) and artery (VFA) were measured by duplex. Division of VFV by VFA calculated VAFI. VAFI-measurenient was repeated 5 times at an interval of ten minutes in 63 subjects (23 PVV, 20 PTS, 20 healthy) and it was performed at three different days in 68 subjects (20 PVV 20 PTS, 28 healthy). Results: Mean VAFI standard deviation was 1.39 +/- 0.26 in PVV, 1.42 +/- 0.26 in PTS and 0.93 +/- 0.13 in healthy veins (p < 0.001). VAFI remained stable and significantly increased (p < 0.001) in PVV and PTS compared to healthy veins during 40 minutes and also within three different days. Conclusion: The venous-arterial flowindex VAFI is a reproducible pattern of the hemodynainic severity, in venous insufficiency.