If a pediatric exam reveals testicular microlithiasis, then regular follow-up is recommended. The exact cause of microlithiasis is currently unknown, and the detailed mechanism is medically unknown. It is speculated that it may be related to epithelial cell detachment obstructing the varicocele while other components, such as calcium, are deposited to form a stone-like structure. It may block the varicocele, affecting the patient’s fertility, and may also cause an increased incidence of testicular tumors. There is generally no absolute symptomatic treatment for this condition, and regular follow-up observation is all that is needed. It is recommended that children have a repeat ultrasound once a year until monitoring into adulthood after childbearing. If there is a combination of pain in the scrotum or infertility, it is recommended to go to the hospital for a further detailed examination and evaluation before taking further treatment options. Oral medication or surgery is usually not required.