The objective of this study was to evaluate scrotal veins contribution to varicocele and the effect of its ligation on the results of subinguinal varicocelectomy. Sixty patients with clinically detectable varicocele grades II and III, abnormal semen, a preoperative diameter of veins of more than three millimeter, and time of regurge more than one second through Valsalva’s maneuver, together with dilated and regurging scrotal veins, were randomly divided into 2 groups: Group I: Subinguinal varicocelectomy only (30 cases). Group II: Subinguinal varicocelectomy with additional scrotal veins ligation (30 cases). Both surgical techniques showed significant improvements in semen parameters (count and motility), clinical grades of varicoceles and Duplex parameters (diameter of veins, time of venous reflux and testicular volume). However, the postoperative improvement in sperm count, time of venous reflux and testicular volume was significantly higher in group II. Postoperative pregnancy rates, recurrence and complications were comparable with no significant difference between both groups.