Spermatic vein ligation is the main treatment for varicocele, based on the theory that there is blood reflux from varicocele and that spermatic vein ligation can effectively stop this reflux. The traditional high ligation of the spermatic vein via inguinal route, retroperitoneal route and laparoscopic high ligation of the spermatic vein are not easy to distinguish the testicular artery and lymphatic vessels during the operation, so it is easy to damage and mistakenly ligate the testicular artery and lymphatic vessels, and it is also easy to miss ligating the spermatic vein, and some of the low spermatic veins return through low side branches and cannot be ligated. This results in a high incidence of postoperative testicular recalcitrant edema or testicular atrophy, and a high rate of postoperative persistence or recurrence of varicocele. Microsurgical techniques for varicocele can greatly reduce these complications, and experts at home and abroad agree that microligation has now become the new standard for the treatment of varicocele. Since our hospital started microsurgery for varicocele, we have relieved more than 500 patients of their pain, and the rate of testicular edema 3 months after surgery and recurrence 1 year after surgery is only 0.72% and 2.07%, and the natural pregnancy rate of the patient’s wife is as high as 44.75% from 3 months to 1 year after surgery. The advantage of this technique is that microscopic ligation under the external inguinal ring can clearly identify arteries, lymphatic vessels and nerves, avoiding intraoperative damage or misligation of arteries and lymphatic vessels, ligating veins more adequately, reducing the recurrence rate of varicocele, and preventing complications such as testicular atrophy and scrotal edema. At the same time, due to the small incision at the outer ring, the patient can be discharged from the hospital in 1~2 days after the surgery, which can effectively reduce the economic burden of the patient. At present, this technology has been identified by experts to fill the gap in Jiangxi Province and has reached the leading level in the province.