No, varicose veins and venous reflux are not the same. Varicose veins are enlarged, twisted veins that are often visible under the skin, while venous reflux is a condition in which the valves in the veins that are responsible for keeping blood flowing in the right direction do not function properly, causing blood to flow backward and pool in the legs. Varicose veins are a symptom of venous reflux, but not all cases of venous reflux will present with varicose veins.