We evaluated the impact of varicocelectomy on the sperm retrieval success rate using microsurgical testicular sperm extraction in men with clinical varicocele and nonobstructive azoospermia. The study included 100 men with complete nonobstructive azoospermia with a clinical unilateral or bilateral varicocele grades II and III. Of the patients 50 underwent successful varicocelectomy and the other 50 patients underwent directly MicroTESE without varicocelectomy.