Varicocele causes about 30% of male infertility with spermatogenetic disorder. Although surgical treatment of varicocele repair has been performed as a standard therapy, controlled trials and meta-analyses generally have not demonstrated improvement in sperm count or fertility after varicocele correction. Therefore, surgical ligation of the varicocele should not be routinely conducted for infertile males with varicocele, except for younger infertile men with a clinically apparent varicocele. Surgical repair is superior to artificial reproductive techniques in cost effectiveness. Microscopic subinguinal ligation of a varicocele with artery preservation is recommended among the treatment methods because of its lower rates of adverse events and recurrence of varicocele.