Varicocele, a common disease in men, occurs mostly on the left side and can occur at any age, and the incidence of varicocele in male infertility patients is 12-15%. When varicocele patients stand up, the scrotum is distended, there is a sensation of cramping and even painful discomfort, which can radiate to the groin or thighs, aggravated when standing and walking, and relieved after lying down and resting. Because varicocele can have a significant adverse effect on the testicles, it can cause abnormal semen quality in men, and studies have found that varicocele is associated with abnormal semen quality in up to 34% of men, which can affect their fertility. However, having varicocele does not always affect fertility, many varicocele patients can also have their own children normally and naturally, the key to fertility is the degree of testicular damage, which can be initially determined by a simple examination of testicular development and function and semen analysis. For patients with infertility combined with varicocele, if the semen examination results are normal, surgery can be temporarily disregarded and regular routine semen examination can be performed every 3-6 months, as long as there is no significant change in semen quality, it can be kept under observation and attention can be paid to finding other factors of infertility, especially the evaluation of the wife’s fertility. Surgery is recognized as the only effective method of treating varicocele, eliminating the local swelling and painful discomfort associated with the disease, and improving semen quality. Indications for surgical treatment include: significant swelling and painful discomfort on the affected side that is unbearable; decreased semen quality that affects male fertility; and atrophy and softening of the testicle on the replacement side. Generally speaking, within 1-2 years after surgery, the improvement of semen routine examination can reach 50%-70%, and 30%-40% of wives become pregnant naturally. However, about half of them still do not have children after surgery. The possible reasons are: late choice of surgery, irreversible damage to the testicles; combination of other factors affecting fertility not removed; infertility factors in the wife. Therefore, a comprehensive fertility assessment must be carried out before the surgical treatment, and the spouse must be examined and treated at the same time, so as to avoid difficulties in having children after the surgical recovery, even if the man’s fertility has been gradually improving and returning to normal. Regardless of the white cat or black cat, the one who can catch the rat is the good cat, and many infertile men are treated for varicocele for the purpose of having a child. For those with more serious conditions, such as significant testicular atrophy, severe oligospermia, or weak spermatozoa; patients who are older and need to solve fertility problems as soon as possible, surgical treatment is not a recommended option. Modern fertility techniques to solve fertility problems are not too difficult anymore.