Azoospermia, which is simply the absence of sperm in ejaculated semen, is often found when a person visits the hospital for fertility problems. There are many reasons for the absence of sperm in semen test results, and one should not see the results and assume that one does not have the next generation, but should actively seek medical attention. Azoospermia must be diagnosed after 2-3 semen analyses and no sperm found even after centrifugation and sedimentation of the semen. Also, the time of sperm collection must comply with the rule of 2 to 7 days of abstinence, and the test must be of semen, excluding all other extraneous factors that may cause errors in the results. The percentage of azoospermia in infertile men is about 19 to 30%. Azoospermia can be caused by different etiologies, and depending on the etiology, different treatment measures can be taken. Some of these etiologies cannot be corrected, and some can be treated to produce sperm and thus gain fertility. The first step is to take a medical history of the patient, for example, to determine whether he or she has ejaculation or retrograde ejaculation, has had mumps, orchitis or epididymitis, etc., which can cause azoospermia. If the patient’s body shape is fat, throat nodes are not prominent, small testicles, etc., this may be azoospermia caused by genetic factors; if varicocele, testicular sphincter, etc. are found, surgical treatment should be performed. Again, ancillary tests, hormone measurements and chromosomal analysis can be performed to diagnose diseases caused by genetic factors. The last thing that can be performed is testicular biopsy, if there is no any spermatogenic cells in the testis and the biopsy confirms irreversible spermatogenic disorder, then there is no way back to heaven; if there are spermatogenic cells, then it may be spermatogenic blockage or vas deferens obstruction, if vas deferens obstruction is considered, then further examination or imaging should be performed to confirm the diagnosis, at this time, drug treatment, surgery to release the obstruction, assisted reproduction and other options can be performed according to different situations. Azoospermia is a refractory condition in male infertility, which is devastating to patients and needs to be given high priority. For the acquired factors causing infertility, it should draw more attention from the general public, such as timely detection and treatment of varicocele, testicular epididymal inflammation and other diseases. For the majority of parents, they should also promptly detect and actively treat their children’s mumps, urinary tract inflammation, etc. and pay attention to their reproductive health.