Background. The patient's view of the outcome after phlebectomy is mainly dependent on the cosmetic result. Objective. To compare 5‐0 monofilament sutures with tapes and tissue adhesive for wound closure after varicose vein surgery. Methods. Seventy‐nine patients undergoing varicose vein surgery were prospectively randomized in three groups (tissue adhesive, sutures, tape) for skin closure and compared. The follow‐up 1 year postoperatively was done by a senior dermatologist who was blinded in the method of skin closure. Results. The cosmetic outcome showed little advantage for the suture group. Taping the incisions is faster than suturing them but without significance; closure with tissue adhesive takes nearly the double of time. The closure for one incision with tissue adhesive is 40 times more expensive than with tapes and 14 times more expensive than with sutures. Conclusion. This study failed to demonstrate an advantage of tissue adhesive and tapes over monofilament sutures for skin closure after phlebectomy.