Testicular biopsy and inracytoplasmic sperm injection (TESE/ICSI) became standard treatment for patients with non-obstructive azoospermia. Demonstration of germinal cells by using touch imprint and fresh examination preparations is a guide for sperm detection. Our study aiming at comparing combined testicular histopathology and touch imprint with fresh examination of testicular tissue in identifying testicular sperms in patients with azoospermia prior to planning for intra-cytoplasmic sperm injection (ICSI). Fifty patients with non-obstructive azoospermia after clinical examination, measurement of serum FSH and semen analysis, underwent testicular biopsy upon which touch imprint, fresh examination and histopathological evaluation were done.