Background: Despite the growing evidence indicating the association between inhalation of traditional incense smoke (IS) and the increased risk of numerous health issues, its possible effect on spermatogenesis is still confusing. Aim: The present study was designed to address the hypothesis that exposure to traditional IS may impact sperm quality and affect liver and kidney function. Material and methods: Using a rat model, we evaluated the effects of IS exposure on semen quality by Computer-Assisted Semen Analysis (CASA) and blood samples were collected for the determination of random blood glucose, C-reactive protein (CRP), liver and kidney function parameters and testosterone levels. Results: Prolonged inhalation of IS caused a highly significant decrease in testosterone levels compared with the control group. Moreover, complete semen analysis indicated that sperm's progressive motility, velocity, and vigor parameters were significantly decreased in IS-exposed groups compared with the unexposed group. Also, IS inhalation significantly increased the percentage of morphologically abnormal sperms. Biochemically, prolonged inhalation of IS caused a significant decrease in blood glucose while blood CRP, liver, and kidney function biomarkers were significantly elevated compared with the control group, reflecting potential toxicity. Conclusion: We concluded that excessive and prolonged IS inhalation may cause a remarkable deterioration in spermatogenesis, sperm quality as well as kidney and liver function.