Introduction: Most studies that linked varicocele (Vx) with male infertility focused mainly on the testis affection, yet it was suggested that Vx can disturb also the epididymis that plays a central role in sperm maturation. Higher concentrations of L-Carnitine (LC) were reported in the human epididymis but few studies have investigated the relationship of seminal LC with male infertility associated with Vx. This study aimed to assess seminal plasma L-Carnitine (LC) levels in infertile oligoathenoteratozoospermic (OAT) patients with varicocele (Vx). Methods: Overall, 86 men were investigated. They were divided into; infertile OAT patients with Vx (n=45), infertile OAT patients without Vx (n=21), and fertile men (n=20) as controls. These cases were subjected to history taking, clinical examination, and semen analysis. Seminal LC levels were estimated by the colorimetric method. Results: The mean seminal plasma LC levels were significantly lower in infertile OAT patients with Vx (216.3 ± 57.1 ng/ml) compared to infertile OAT patients without Vx  (252.9 ± 62.9 ng/ml, P= 0.01), or fertile men (382.8 ± 63.6 ng/ml, P=0.001). Besides, the mean seminal plasma LC level exhibited significant decreases in infertile OAT patients of Vx grade III compared to Vx grade II cases, and in infertile OAT patients of bilateral Vx compared with unilateral Vx cases. Collectively, there was a significant positive correlation between seminal LC levels with sperm concentration, motility, and normal forms. Conclusion: Seminal LC levels are expressively reduced in infertile OAT patients with Vx influenced by an escalation of its grade and bilaterality.