Background: Varicocele is approached by various interventional techniques, none of which is yet considered the best. Some are relatively expensive, time-consuming and require special skills and training especially microsurgical techniques.
Objectives: Evaluation of scrotal veins contribution to varicocele and the effect of its ligation on postoperative varicocele grade and Duplex parameters.
Patients and methods: Sixty patients with clinically and sonographically detectable varicocele  grades II and III, abnormal semen, a preoperative diameter of veins of more than three millimeters, and time of regurge more than one second through Valsalva's maneuver, together with dilated and regurging scrotal veins, were randomly divided into 2 equal groups: Group I were treated by subinguinal varicocelectomy only, and Group II were treated  by subinguinal varicocelectomy with additional scrotal veins ligation.   
Results: Both surgical techniques showed significant improvements in clinical grades of varicocele and Duplex parameters (diameter of veins and time of venous reflux). However, the postoperative improvement in time of venous reflux was significantly higher in group II. Recurrence and complications were comparable with no significant difference between both groups.
Conclusion: The improvement in clinical grades of varicocele and Duplex parameters was insignificant in both surgical techniques. Improvement in time of venous reflux was significantly  higher in patients treated by subinguinal varicocelectomy with additional scrotal veins ligation.