Bluish and red-colored spider veins along the inner ankle and foot are referred to as corona phlebectasia in the vein world. This description refers to the ‘crown’ or cluster like distribution of these small blood vessels. Spider veins are often falsely considered as a cosmetic issue. But on the contrary, the presence of corona phlebectasia is a clinical sign that is often associated with underlying venous reflux, most commonly saphenous vein reflux, but the deep or perforator veins can also be incompetent. The underlying disease can be evaluated by a duplex ultrasound examination. Whenever corona phlebectasia is present, a duplex ultrasound examination should be offered to evaluate the underlying cause for the development of spider veins around the ankle. This will help accurately determine the treatment plan.