The diagnosis of ejaculatory duct obstruction (EDO) is of importance since it is a surgically correctable cause of male infertility. In this study, TRUS guided seminal vesicle aspiration, seminal vesiculography, and cyst aspiration and dye injection were used to confirm TRUS findings of EDO. Out of 35 patients diagnosed by TRUS as having EDO, only 23 were confirmed to have EDO using these techniques. In conclusion, TRUS is a useful screening tool for EDO; however a TRUS diagnosis of EDO needs further confirmation by TRUS guided techniques. Furthermore, these techniques may have a therapeutic potential.