Background: surgical correction of varicocele is the corner stone of its therapy and varicocelectomy is the most commonly performed operation for the treatment of male infertility. Aim: to compare the outcome of the most common surgical approaches; sub-inguinal varicocelectomy and laparoscopic varicocelectomy as regards: operative difficulties & time, complications and efficiency. Patients and Methods: This randomized controlled study was conducted on 40 patients, divided into two groups: group I included 20 patients, were operated upon through the subinguinal approach and group II included 20 patients, were operated upon through the laparoscopic approach, and comparison between two groups as regard outcomes and complications. Results: It was found from this study that the operation time was relatively shorter with the laparoscopic technique (p<0.01), while the length of hospital stay and post-operative complications did not differ in both methods. Follow up of patients at 3 and 6 months showed a marked improvement in semen analysis in terms of concentration, the percentage of abnormal forms, movement, and also there was a marked improvement in testosterone hormone. Conclusion: In both methods, results were almost the same, but the sub inguinal approach is qualitatively better in terms of the lack of complications, but with delayed return to work compared with laparoscopic technique.