Although varicocele is a “small” disease, there are many surgical methods. So far, the accepted surgical approaches can be divided into two categories: (1) open surgery: inguinal and retroperitoneal high ligation and retroperitoneal artery-preserving high ligation; (2) minimally invasive surgery: laparoscopic varicocele high ligation and spermatic vein interventional embolization. Another category is diversion, including superficial inferior abdominal wall vein – internal spermatic vein diversion, internal spermatic vein – external iliac vein diversion, etc. In general, all surgical methods are relatively simple (including diversion). With the advancement of time, minimally invasive laparoscopic and interventional embolization for varicocele is accepted by more and more patients and physicians. However, there are differences between laparoscopic and interventional embolization, mainly as follows: laparoscopic ligation: high success rate, requires general anesthesia or epidural anesthesia, slightly more costly, slightly more traumatic, and slightly more complications. General anesthesia or epidural anesthesia has its advantages and disadvantages, and is higher than interventional embolization in terms of complications and length of hospital stay and costs. Due to artificial pneumoperitoneum, all arterioles and lymphatic vessels are compressed and narrowed during surgery due to the effect of gas abdominal pressure, and it is difficult to perform highly selective ligation of only the spermatic veins while preserving the internal spermatic arteries and lymphatic vessels in all cases. The ligation of the arteries and lymphatic vessels can lead to complications. Interventional embolization: Minimally invasive, local anesthesia, with the possibility of prior imaging and a more visualized patient experience of the diagnosis and treatment of the disease. It is generally less likely to recur because the main trunk of the internal spermatic vein is embolized under very clear instructions. In some cases, the embolization failure rate can be around 5% due to vascular variation, although the imaging provides better guidance for subsequent treatment. For concerns about radiation damage, low radiation DSA can be used as much as possible, avoiding treatment under conventional X-ray machines as much as possible, and intraoperative attention to perineal coverage is also a useful way to reduce radiation.