Microdiscectomy of varicose spermatic veins is the most common procedure for the treatment of male infertility. Compared with open, laparoscopic, percutaneous puncture and other surgical methods, microsurgery has its obvious advantages: it accurately identifies and protects the testicular artery and its branches, the levator artery and its branches, and reduces the incidence of testicular atrophy and azoospermia after surgery; intraoperative exposure of the testis allows visual observation of all testicular reflux veins, including the internal spermatic vein, the external spermatic vein, the levator muscle vein, the vas deferens vein, and the collecting vein. In addition, intraoperative exposure of the testis helps to detect microscopic testicular tumors and epididymal/vas deferens obstruction that are often overlooked; fewer lymphatic vessels are misplaced and the incidence of postoperative syringomyelia is reduced. Advocates of open surgery believe that a misligated testicular artery, along with the vas deferens artery and levator artery, ensures testicular blood supply and is sufficient to prevent testicular atrophy, but anatomic studies have found that the testicular artery at the site of high spermatic vein ligation is larger in diameter than the sum of the latter two and is a true testicular blood supply artery, and the effects of a misligated artery are far greater than those that may occur during microsurgery. Overall, microsurgery is safe, reliable, and has fewer complications, and is gradually being accepted and adopted.