Small azoospermic testicles have the potential for successful fertility after effective treatment. The testicles are important male reproductive organs that produce and store sperm, secrete androgens, and maintain normal male reproductive function. If the testicles are small, it may lead to insufficient sperm production. Small testicles without sperm are mostly related to congenital developmental abnormality of testicles or insufficient secretion of sex hormones, which can usually be treated by supplementation of sex hormones. It is recommended that the patient under the advice of the doctor for testicular puncture, and sex hormone six test , in order to determine the semen and the body’s hormone levels. Testosterone undecanoate capsules are also recommended to promote testicular development. If necessary, an orchiectomy can be performed to determine the quality of sperm or to obtain mature sperm. Patients with small testicles and no sperm need to be treated correctly under the guidance of a professional doctor, and the medication needs to be taken under the guidance of a doctor to avoid adverse consequences.