Our study included forty patients recruited from the Andrology clinic Kasr El-Aini hospital. Semen analysis showed repeated normal volume azoospermia, serum FSH was in the normal range, local examination showed normal sized testes, full epididymis or the presence of epididymal nodules with palpable vasa, testicular biopsy( if previously done) showed normal spermatogenesis. The patients were divided into three groups according to surgical technique. Group A: included 20 patients treated by conventional vasoepididymostomy,Group B: included 10 patients treated bymicrosurgical vasoepididymostomy by triangulation end to side technique and Group C: included 10 patients treated by microsurgical vasoepididymostomy by simultaneous double needle placement end to side technique.The highest patency was accomplished in group (B) 40% (4 cases out of 10), followed by patency in group (A) as 25% (5 cases out of 20), the lowest patency was achieved in group © as 20% (2 cases out of 10).Although the patency rate was higher in group (B) there was no statistical significant difference of patency between groups (B) and ©, (P= 0.4). Patency was reported to be higher in the microsurgical (30%) versus the conventional group (25%), but there was no statistical significant difference of patency between both groups, (P=0.7). Pregnancy rate in group (A) was 20% while in group (B) it was 25%, natural pregnancy was not achieved in relation to group ©. Regarding the duration of infertility patency was higher (46.2%) in cases with < 4 years duration of infertility compared topatency rate of 18.5% in cases of > 4 years duration infertility. (P value = 0.1). Patency was reported to be higher in obstructive cases due to infection (38.5%) (10 cases out of 26) compared to patency rate of 7.1% (1 case out of 14) in idiopathic cases. (P=0.06)The mean total count in group (A) was 6.4 millions/ml (mean motile count=1.9 millions/ ml). In group (B) the mean total count was 9.2million/ml (mean motile count=2.3millions/ ml). In group© the mean total count was 4.0 million/ml (mean motilecount=1.1millions/ ml).The mean operative time in conventional EV was 78.25 minutes while in triangulation group it was 173 minutes and in double needle placement technique it was 196 min. Late failure of EV: was noticed in a 12 months duration of follow up in 2 out of 5 cases (40%) of group (A), while in group (B) it was 1 out of 4 cases (25%), in group © 1 of 2 cases (50%).