It s not serious don t worry.. Hi and welcome to HCM.. I thank you for posting your query here and I m definitely going to help you out.. I being a surgeon, we encounter so many such cases day in and day out.. I read your question completely and have understood it well enough... Pulsating vein in the region of foot has few differential diagnosis.. Well, I will analyze all your points and give you the plan on how to go about.. 1. You say you have pulsating vein near 1st metatarsal.. If it s there all the time then I need further information. A. When did it start.. B. How did it start, like any history of trauma or something C. If it s present since birth then all chances of AVM. Arterio venous malformation. 2. No pain, again indicates AVM.. 3. So in all likelihood hood it can be.. A. AVM.. B. AV fistula.. C. Very rarely Varicose veins. Because this condition won t be pulsatile like how you describe. 3. Now how to go about.. Basically, the cause has to be identified, like trauma, congenial, any other associated problems etc.. 4. Better to go for soft tissue scan. If it s significant then you ll need MRI of foot involving that area. With this, we can know the exact diagnosis and later plan for treatment or surgery. 5. So MRI or MR Angiogram is the best diagnosis.. 6. I can guide further.. Hope this helps you, in case you need any further assistance, please let me know.. Take care and God bless you..