Purpose: surgical ligation is an option in the management of patients with painful varicocele. We submitted varicocele ligation for (30) patients at El-maadi armed forces hospital to establish success of surgical ligation of the painful vaicocele.Materials and Methods: History taken for the patients included age, grade and location of varicocele, duration and quality of pain, response to conservative therapy and marital status of the patients. Testicular ultrasonography, duplex u/s and semen analysis was done preoperatively. The techniques of ligation was high, inguinal and laparoscopic ligation techniques. Follow up duration was 7 months (average 3-12 months), during which resolution of pain, complications of the procedure and associated improvement in semen quality was determined. Results: we obtained follow up on the 30 patients with painful varicocele. Average patients age was (25.7) years (range 20-35), varicocele was on the left side in (25) men and bilateral in (5). Of the patients (8) described the pain as a throbbing ach, (19) as dull ache, (2) as pulling sensation and (1) as sharp pain. Initial conservative therapy failed in all (30) men. Varicocele was grade III in (15) cases, grade II in (13) and grad I in (2) patients. The inguinal approach was used in (10) patients, high ligation in (10) and laparoscopic repair in (10). In (25) patients there was (83%) complete resolution of pain postoperatively and (1) had partial resolution. Only (4) patients (13.3%) had persistent or worse symptoms.Conclusion : this study supports the conclusion that varicocele logation an effective treatment for painful varicocele in properly selected patients with success rate of (83%).