Background: Varicose veins are twisted, widened veins in the subcutaneous tissues of lower limbs and are often easily visible. The primary cause of varicose vein formation is not clear. An imbalance between Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) have been implicated in some studies The aim of this study was to study the role of MMP-9 which belong to the subclass of gelatinases of MMPs. Materials and Methods: 58 male patients in the range of 18-35 years undergoing surgery for varicose veins were selected for the study and compared with normal veins extracted from a similar group undergoing herniorrhaphy for a groin hernia. Immunohistochemistry was performed in these specimens using a kit procured from Biogenex Results: MMP-9 in all 58 cases in comparison to controls show differential expression between the layers of veins. strong immune positivity of MMP-9 (3+) was predominantly observed in the tunica adventitia in vasa vasorum (14 patients). However, 29 out of 58 patients (50%) did not show any expression in the tunica intima. Hence, our observation of MMP-9 in varicose veins showed high expression in tunica adventitia and tunica media, in comparison to tunica intima. Conclusion: MMPs play important roles in the biological and pathological processes leading to varicosities. Hence, drugs aiming at the inhibition of MMPs or balancing of MMPs are of significant utility. Future studies should expand on the possibility of hemodynamic and saphenous vein grafts capable of altering biomarkers and biochemical signalling, which can assist vascular remodelling .This knowledge is critical to developing novel treatment protocols and preventive approaches against varicose veins