The present work investigates the outcome of Fresh Testicular Biopsy in Comparison to Histopathological Examination in NOA Patients. In the current study, there were nine discordant instances (16.9%) between the andrology lab and histology. Histopathology characterised these cases as hypospermatogenesis, but andrology reported one case of SCO, three cases of spermatocyte, and five cases of late spermatid. To our knowledge, no study done before to examine the biopsy from NOA patients who have negative sperm retrieval in a fresh examination on the side of histopathological examination. Our intention of this study is to compare and evaluate the difference between both fresh and histopathology examinations in order to test our Andro lab results in such patients. We found in our series that (16.9%) of the patients have sperms in histopathology examination in whom we couldn't retrieve sperms in Andro lab. These results may guide us towards Auditing and improvement of a fresh examination of testicular biopsy.