Accumulating evidence suggests that varicocele, long associated with male infertility, is also a risk factor for low testosterone levels. The exact pathophysiology of the negative effects of varicocele on testicular function is not well understood, but theories include venous stasis, increased testicular temperature, oxidative stress, and resulting toxic environment. While prior studies report conflicting effects of nonmicrosurgical varicocelectomy on testosterone level, recent literature demonstrates that microsurgical varicocelectomy improves testosterone levels in men with varicocele and low testosterone preoperatively.