There are many people online with ultrasound reports of the spermatic veins, wondering whether the values of spermatic vein internal diameter and reflux are normal or abnormal; and if they are abnormal, whether they are serious or not. These questions are troubling the patients, and the following are the initial answers to these questions, of course, there are other diagnostic and grading criteria besides ultrasound, which are not within the scope of this article. Definition: Varicocele is a condition in which the trapezius plexus of the spermatic cord has poor reflux or venous reflux due to various causes, resulting in abnormal expansion, elongation and tortuosity of the local veins and the formation of vascular masses in the scrotum. Varicocele can lead to male infertility, and in serious cases, it can lead to scrotal swelling and discomfort that affects work and life, so it needs to be treated. Ultrasound diagnostic criteria of varicocele: Varicocele can be diagnosed if the following two items are met at the same time. 1. the maximum internal diameter of the spermatic vein (DR) ≥1.8mm during calm breathing, and the DR ≥2.0mm during Valsava test (when the patient stands and holds his breath to increase the abdominal pressure, the examination of the spermatic vein in the scrotum is the Valsava test); 2. positive Valsava test, that is, the color and spectral Doppler detects the reflux signal during Valsava test and the duration of reflux 3. Ultrasound grading criteria According to the clinical and ultrasound diagnosis, varicocele is divided into 4 grades, which are subclinical varicocele, clinical varicocele grade I, grade II and grade III. 1. Subclinical varicocele: negative clinical palpation and reflux in spermatic veins on ultrasound, DR: 1.8-2.1mm, TR: 0.8-2s; 2. Clinical varicocele grade I: positive clinical palpation and DR: 2.2-2.7mm on ultrasound, TR: 2-4s; 3. Clinical varicocele grade II: positive clinical palpation and DR: 2.8-3.1mm on ultrasound; 4. 2.8-3.1mm, TR: 4-6s; 4. Clinical varicocele grade III: positive clinical palpation and ultrasound DR ≥3.1mm, TR ≥6s. IV. Treatment of varicocele 1. Conservative treatment: Patients with no symptoms or mild symptoms and no fertility requirements can try non-surgical treatment, including scrotal brace, local cold compresses, oral Chinese and Western medicines, etc.; 2. Surgical treatment: It is the most effective method, including open surgery, laparoscopic surgery and microscopic surgery. It is suitable for patients with varicocele with male infertility, those who have serious symptoms or those whose symptoms are not significantly relieved by non-surgical treatment. Because the incidence of varicocele is close to that of adults in late adolescence, the older the age and the longer the course of the disease, the more severe the damage to testicular function and the less likely it is that fertility will be restored; therefore, surgery should be performed as early as possible in adolescence. Surgery is advocated for grade III varicocele in childhood to avoid affecting the reproductive function.