Varicocele must be regarded of the utmost importance in determinating male infertility. Surgical indications should be considered of primary interest in order to achieve a qualitative and quantitative improvement in spermiogram parameters in the majority of the cases. Recent reports showed that it is not the severity of the lesions to determine the alterations in seminal parameters but the length of time of the varicocele. In our report we consider the results achieved on the spermiogram parameters in two groups of 25 patients surgical treated with different techniques. The first group was treated, in others Centers, by means of the traditional technique of ligature of the spermatic vein (Ivanissevich, Palomo). We treated all the patients of the second group (53 patients) with microsurgical technique of anastomosis pampiniform plexus-saphenous vein, and we control the sepermiogram parameters in 25 patients. The first group showed an improvement of the spermiogram parameters after 6 months from the surgical treatment in the 64% of the cases, while in the second group the improvement was of the 92%. Moreover we registered the persistence of this improvement after 12/36 months from the operation time. On the basis of these observations we think that the microsurgical technique leads to the best and longest results on the most invalidating cause of this pathology.