Background: Varicocele is abnormal dilatation and tortuosity of the testicular vein within the spermatic cord. Laparoscopic varicocelectomy is a minimally invasive procedure that can easily be performed by simple instruments. Not only can the bilateral varicocele be easily dealt with through the same ports, but other procedures, such as hernia repair, can also be simultaneously performed. It is the best approach when recurrent disease and obesity are problems. Objective: To assess and compare between the open and laparoscopic varicocelectomy approaches in treatment of varicocele as regards postoperative results, complications and efficacy of the technique. Patients and methods: This prospective study was done on 30 patients with primary varicocele at Aswan University Hospital. They were classified into two equal groups. Group-A underwent open subinguinal varicocele repair. Group-B underwent laparoscopic varicocelectomy using the intraperitoneal approach. Results: There were no significant differences between both groups as regard age and laterality. Postoperative pain was reported in 100% of patients in both groups. The open subinguinal procedure and laparoscopic varicocelectomy showed significant difference as regarding postoperative complications in favor of laparoscopic procedure, while both procedure showed no significant difference regarding improvement of semen parameters. Conclusion: Laparoscopic varicocelectomy is better than open technique as regard operation time, postoperative complications (Wound erythema, wound infection, epididymitis, and recurrence) and postoperative hospital stay while other studies revealed that the microsurgical technique is the best of all.