Varicocele is a common disease in male medicine; statistics show that the prevalence is about 15% in the general population, and 75%-85% of patients with varicocele cause secondary infertility. In recent years, in our clinical work, we have found a trend of lowering the age of varicocele incidence; clinics now often find patients around 12 years old with obvious varicocele symptoms. Varicocele is a vascular disease characterized by varying degrees of dilatation and tortuosity of the trabecular plexus in the spermatic cord. Varicocele may be caused by increased intravascular pressure, the left spermatic vein travels long and converges at right angles to the left renal vein, superior mesenteric artery and aorta to compress the left renal vein, which affects the reflux of the left internal spermatic vein, i.e., the “nutcracker” phenomenon, weak connective tissue around the internal spermatic vein and venous valve dysfunction, incomplete closure, and abnormal tissue structure of the spermatic vein wall. The phenomenon of “Nutcracker” is caused by the weakness of connective tissue around the internal spermatic vein and venous valve dysfunction, incomplete closure, abnormal tissue structure of the spermatic vein wall, anatomical variation of the spermatic vein and underdevelopment of the levator muscle. Clinical grading: Grade I: examination by pharyngeal tube pinching and nasal puffing; Grade II: no nodular masses in the scrotum lying down, but obvious varicose veins can be seen by standing or abdominal pressure; Grade III: varicose veins can be seen in the scrotum, and palpation feels like “earthworms in the pocket”. If at least three or more spermatic veins are detected in the spermatic plexus under calm breathing, and the inner diameter of one of them is >2.0mm, or the inner diameter of the vein increases significantly when abdominal pressure is increased, or the diagnosis is established after Valsalva test with significant venous blood reflux. Indications for surgery: 1, varicose veins with abnormal testicular development; 2, varicose veins with obvious clinical manifestations, presenting grade II or above; 3, spermatic veins with inner diameter >2.0mm on ultrasound examination or with obvious increase in inner diameter when increasing abdominal pressure, or with obvious reflux of venous blood after Valsalva test. Surgical methods: 1, high ligation of the spermatic artery; 2, high ligation of the internal spermatic vein; 3, selective ligation of varicocele under microscope; currently, some foreign scholars use X-ray assisted highly selective varicocele ligation plus sclerotherapy injection, but no matter what method is used, the recurrence rate is about 6% after surgery. Complications of surgery: 1, edema; 2, testicular atrophy; 3, varicose vein recurrence. At present, laparoscopic varicocele selective ligation and microscopic varicocele ligation are often chosen in the clinic; the surgery is less invasive and there are fewer complications such as postoperative testicular atrophy and testicular edema. Varicocele surgery is less traumatic for patients and requires no special treatment after surgery, and most patients can resume normal activities 2-3 days after surgery; however, for older patients with more severe symptoms, it is recommended to stay in bed for 3 days after surgery and elevate the scrotum to promote blood flow back. Infertility is related to varicocele, but it is not the only cause; varicocele surgery is mainly performed in the short term to improve testicular function and semen quality; for adolescent patients, semen examination should be performed at puberty to determine the long-term prognosis.