What is varicocele? It is a progressive disease of the spermatic cord in which the veins of the spermatic cord become dilated due to obstructed reflux or the venous valves become dysfunctional, causing abnormal dilatation, elongation and tortuosity of the trapezius plexus in the spermatic cord. Varicocele is the most common cause of testicular reproductive dysfunction leading to male infertility, and is also a correctable factor among the various causes of male infertility. Varicocele can usually be clinically diagnosed by physical examination and ancillary tests. Conservative treatment of varicocele is not effective, and surgical treatment should be recommended for patients with varicocele with abnormal semen parameters, or for those with clinically significant symptoms, or for adolescent patients with significantly smaller testicular volumes than the opposite side. The main surgical procedures include open surgery, laparoscopic surgery, microsurgery, vascular embolization, etc. The main surgical complications include recurrence of varicocele, testicular syringomyelia and testicular atrophy. Although comparative studies on the long-term safety and efficacy of various surgical treatments for varicocele have shown that microsurgical varicocele repair improves reproductive function more significantly than results reported for other surgical modalities, with a 65% improvement in semen parameters and a 40% increase in the chances of spousal conception, and the least recurrence and complications after varicocele surgery. Microsurgical treatment of varicocele is the most effective and is becoming popular. Nevertheless, there is a lack of evidence-based, well-designed research protocols and large comparative studies evaluating the safety and efficacy of various surgical treatments for varicocele in men with infertility. Some studies suggest that the use of some adjuvant drugs and herbal preparations may be helpful in improving postoperative semen quality and conception rate in varicocele, which needs to be studied in depth.