Levocarnitine (L-carnitine) is a naturally occurring vitamin-like substance, also known as vitamin BT, that plays an important role in the body’s energy metabolism. In the past, it has been studied more for its clinical applications in cardiac diseases and maintenance dialysis. In the last decade or so, new clinical studies have shown that levocaine and its metabolite acetyl levocaine have high concentrations in male epididymis, spermatozoa and semen, and it plays an important role in the treatment of male infertility. The epididymis is the site of human sperm maturation and storage, and is directly related to sperm motility and fertilization ability. As an important component of the epididymal fluid leucovorin has extremely important physiological functions. Levocannabinoids taken up from the blood are secreted by the epididymal epithelium into the lumen through an active transport mechanism, resulting in high levels of leucocannabinoids in the epididymal fluid. The concentration of leucanidine in the epididymal fluid in the caudal part of the epididymis is even hundreds of times higher than in the plasma. Spermatozoa from the testes do not enter the epididymis at the head and their lecanidin levels are very low or undetectable; during the transit of sperm from the head to the tail of the epididymis, flagellar motility and the accumulation of high levels of free lecanidin in the epididymal ductal fluid begin to occur. All of these suggest a close association between leucanidine and sperm motility. One of the functions of lecanetine in sperm is to transport fatty acids into the mitochondria of spermatozoa, thus assisting in energy production. Second, free lecanetin reacts with excess acetyl coenzyme A, which is produced during energy production in mature spermatozoa, to form acetyl lecanetin. This buffering reaction reduces the level of acetyl coenzyme A and acts as a storage for free coenzyme A, which facilitates the continuation of energy production in sperm. It has been found that the concentration of free leucovorin in semen correlates with sperm count, sperm motility and the density of motile sperm in the semen of infertile men. The acquisition of viable sperm capacity coincided with an increase in the concentration of free leucovorin in the epididymis. In the same population, total leucovorin concentration in spermatozoa and sperm motility were reported to be directly correlated, while total leucovorin concentration in semen and sperm count were correlated. The treatment of male infertility with oligozoospermia with lecanetine has received much attention in recent years. The results were good. Shang Xuejun et al. reported the clinical observation of 35 cases of L-carnitine treatment for epididymal nodules with weak spermatozoa, among the 32 patients who completed the treatment, semen quality improved significantly in 28 cases, except for 4 cases in which semen quality did not improve significantly. The main semen parameters such as forward sperm motility, total motility, curvilinear motility velocity, linear motility velocity and mean trajectory velocity were significantly improved after 3 months of L-carnitine treatment (P0.01), and 4 spouses became pregnant during the treatment period and 2 months after the treatment, one of which had a normal delivery. Recent studies have shown a correlation between levocarnitine and semen parameters such as sperm density, motility, and percentage of normal sperm morphology. The use of levocanidine and/or acetyl levocanidine for the treatment of male infertility such as oligozoospermia and hypospermia has been reported with some efficacy. As a well-targeted, safe and effective as well as non-hormonal therapeutic drug, levocarnitine and/or acetyl levocarnitine, alone or in combination with other therapeutic methods, may have broad applications in the treatment of epididymal hypospadias or disorders due to inflammation, etc.