A new therapeutic approach to idiopathic varicocele, promoting restoration of the venous return in a physiological manner is described. The procedure consist in the creation of anastomosis between the veins of plexus pampiniformis and vena circumflexa ilium profunda or vena epigastrica inferior profunda using microvascular surgical technique. A brief literature survey of the existing microsurgical methods of varicocele treatment is done. The new method is applied to thirty-seven patients. The microsurgical technique, used in 1991 for the first time, is described in details. The early postoperative results are analyzed. Venous return through the newly constructed anastomosis is verified by Doppler sonography.